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Description
The Network Services Associate will handle data entry, analyze data sets, handle incoming Provider Calls and help with Reconsiderations. It is imperative that the Network Services Associate possess exemplary customer service skills, have a demonstrated ability to work independently, and function effectively as a member of the PSN team.
DUTIES AND RESPONSIBILITIES:
• Responsible for complying with Paradigm IT security requirement and policies.
• Responsible for safeguarding Paradigm or Paradigm related IT passwords.
• Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management.
• Answer in-coming calls during business hours as needed, and reply to phone messages left overnight when the phones are not staffed
• Provide phone support, email and mail communications with both clients and providers. Treats all customers, internal and external, in a courteous and cooperative manner.
• Handle Bills and medical records and follow all necessary HIPAA & PHI compliant regulations
• Handle Provider Reconsiderations
• Handle Client repricing sheet requests
• Document and update information in cases with high degree of accuracy
• Must utilize critical thinking skills while handling billing issues
• Perform additional duties as identified and directed by management.
Requirements
• College education preferred with a minimum of two years in a clerical setting (preferably healthcare).
• Prefer either workers’ compensation or call center experience
• Proficient computer and telephone skills
• Knowledge of Microsoft Applications-Specifically Outlook, Access, Word and Excel. Familiarity with computerized databases
• Thorough knowledge and working experience handling UB and HCFA claim forms and correct data field entries for all fields on both standard billing documents and medical terminology
• Ability to express ideas clearly, concisely and effectively, verbally and in writing.
• Scanning/faxing experience required
• Medical office or insurance experience a plus
• Bilingual (English/Spanish) a plus.
PM19