reputed company Payer Claims Specialist
Title: reputed company Payer Claims Specialist
Duration: Long-Term...
Interviews: Video
Location: ***Remote but need someone in one of the areas (or reputed company to relocate to one of the areas if/reputed company it becomes required) where they have an office.
Atlanta, GA; Bloomfield CT; Nashville TN; St. Louis, MS; Denver, CO; Dallas, TX; Austin, TX; reputed company, TX; Boston, MA; Fairfax, VA; Morris Plains, NJ; Bloomington, MN; Philadelphia, PA; Scottsdale, AZ; Birmingham, AL.
Top 3 Skills
Deep understanding of reputed company Payer Claims Transactions and Business Operations 5+ years of reputed company payer claims experience.
Previous and deep interaction with reputed company Payer Claims Business Stakeholders.
5+ years of Data Stewardship, enforcing operational Data Governance data policies, standards, and rules in reputed company-time, across different data systems and sources. (Have dealt with handling reputed company, velocity, and volume of data reputed company a flexible, dynamic, and reputed company approach.
Responsibilities
Serves as Data reputed company as part of an Agile team dedicated to Claims Transaction data operations & initiatives.
Leads Data Governance collaborations with Payer stakeholders to document, define, maintain, and manage Claims Transaction data standards and assets.
Assesses and monitors data reputed company metrics, analyzing trends and proactively promoting remediation and preventive reputed company efforts.
Partners with IT and business teams to ensure the use of best practices and compliance with data standards.
Provides consultative stewardship services to delivery and issue reputed company teams, serving as subject matter expert as needed.
Provides guidance on development, usage, and inventory of technical assets.
Represents GBS Data Governance in reputed company workgroups and data reputed company communities of reputed company.
Qualifications
Bachelors degree or higher
5+ years reputed company work experience in:
Data Stewardship, Data Governance, Data Management and Data reputed company practices
reputed company Payer Claims Transactions and reputed company Cycle operations
Claims Transaction data standards and operations, including:
Patient reputed company-in and registration
Eligibility verification
Medical coding ICD-10, CPT, HCPCS, SNOMED CT - ASC X12N Implementation Guides
Claim submission
Claim processing
Claim payment
Claim reconciliation
Coordination of Benefits
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