Repricing-Pm Coordinator

Allied Benefit Systems, LLC Chicago , IL 60607

Posted 1 week ago

Apply

This Job is not relevant Tell us why

Department: Repricing/PM Department

FLSA Status: Non- Exempt

Job Status: FT

Reports To: Assistant Manager of Repricing/PM

Positions Supervised: N/A

Work Schedule: Monday through Friday;Flexible full-time hours

Assessments: Predictive Index Cognitive and Behavioral Assessments

Position Summary

The Repricing/PM Coordinator is responsible for re-pricing medical (CMS1500, UB04) and dental claims through the use of multiple applications to obtain discounted rates. Additionally, provide assistance to the Provider Maintenance Team and assist with the year-end B Notice Project.

This position requires a person that is well organized and can work independently and must be able to work under extreme pressure and meet deadlines.

Essential Functions

Repricing of CMS1500 and UB04 forms for various PPO networks
Ability to use several different computer applications to obtain the information needed to correctly reprice a claim
Ability to key claims once repriced into the QicLink system
Ability to communicate effectively with various departments to resolve issues
Must be able to re-price and key claims with a minimum of 99% accuracy

Position Qualifications

Communication Communicates effectively both internally and externally, where applicable. Includes both written and verbal communication.

Dependability Meets deadlines, works independently, accountable, maintains focus, punctual, and maintains good attendance record.

Initiative Takes action independently, seeks new opportunities, and strives to see projects to completion.

Interpersonal Skills Builds strong relationships, is flexible/adaptable, works well with others, and solicits feedback.

Job Knowledge Understands the facets of job, aware of duties and responsibilities, and keeps job knowledge current.

Organization Skills Information organized and accessible maintains efficient work space, and manages time well.

Problem Solving Strives to understand contributing factors, works to resolve complex situations.

Productivity Manages workload, works efficiently, and meets goals and objectives.

Quality Strives to eliminate errors, accurate work is a priority, seeks opportunities to improve product/services

Self-Development Looks for opportunities to increase knowledge, works to increase responsibility, strives to achieve personal goals and/or maintains licenses and other pertinent requirements.

Teamwork Accountable to team, works to meet established deliverables, appreciates view of team members, and respectful.

Technical Skills Maintains current understanding of technical process/equipment, uses technology to increase performance/productivity; effectively uses online tools and resources.

Requirements

Education

High School Education or GED required.

Experience

Experience with HCFA and UB92s a plus but not a requirement.

Skills & Abilities

Microsoft Word, Excel, Outlook, Access databases software programs

Ability to key a minimum of 10,000 keystrokes per hour.

Other Requirements

Fast accurate keying of both alpha and numeric information.

Physical Demands

Ability to sit and type for long periods of time.

Work Environment

Clean professional in-office environment

Show Full Description

See how you match
to the job

Upload my resume

Download the
LiveCareer app and find
your dream job anywhere

Similar Jobs

View All

Want to see jobs matched to your resume?
Upload One Now!

Supervisor Repricing

Allied Benefit Systems, LLC

Posted 2 months ago

VIEW JOBS Job Title: Supervisor, Repricing Department: RepricingFLSA Status: ExemptJob Status: FT Reports To: Assistant Manager, RepricingPositions Supervised: Repricing Department Work Schedule: Monday – Friday, Normal business hours POSITION SUMMARY The Repricing Supervisor oversees daily reporting and tracking of Repricing department workflows, training, and maintaining manuals and documentation. This position works directly with Allied’s vendors and PPO networks to facilitate new business setup and assist with team development and performance. ESSENTIAL FUNCTIONS <ul> <li>Oversees work activities and monitors workflow to ensure systems and procedures are documented, training material developed, and reports generated to meet business needs. </li> <li>Motivates team members to ensure efficient and effective operational outcomes. </li> <li>Leadership responsibilities include training staff; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems. </li> <li>Review of all inbound Appeals and distribution. </li> <li>Track claim adjustment projects. </li> <li>New Business and renewal setup and coordination. </li> <li>Perform back up to support the team as needed. </li> <li>Lead and collaborate ad hoc projects. </li> <li>other duties as assigned </li> </ul> POSITION QUALIFICATIONS <ul> <li> Communication – Communicates effectively both internally and externally, where applicable. Includes both written and verbal communication.</li> <li> Employee Management – Defines responsibilities, motivates employees, delegates well and rewards appropriately.</li> <li> Initiative – Takes action independently, seeks new opportunities, and strives to see projects to completion.</li> <li> Innovation – Creative, offers new ideas, risk taker and amenable to change.</li> <li> Interpersonal Skills – Builds strong relationships, is flexible/adaptable, works well with others, and solicits feedback.</li> <li> Job Knowledge – Understands the facets of job, aware of duties and responsibilities, and keeps job knowledge current.</li> <li> Leadership – Provides strong leadership, sets a good example as a skilled decision maker, motivator and encourager.</li> <li> Problem Solving – Strives to understand contributing factors, works to resolve complex situations.</li> <li> Productivity – Manages workload, works efficiently, and meets goals and objectives.</li> <li> Quality – Strives to eliminate errors, accurate work is a priority, seeks opportunities to improve product/services</li> <li> Self-Development – Looks for opportunities to increase knowledge, works to increase responsibility, strives to achieve personal goals and/or maintains licenses and other pertinent requirements.</li> <li> Teamwork – Accountable to team, works to meet established deliverables, appreciates view of team members, and respectful.</li> <li> Technical Skills – Maintains current understanding of technical process/equipment, uses technology to increase performance/productivity; effectively uses online tools and resources.</li> </ul> SKILLS & ABILITIES Word – Intermediate Excel – Intermediate or better Access – Intermediate or better Communication – excellent written and verbal Experience Minimum two (2) years supervisory experience Medical claims process, billing, experience a plus Education High School education required Certificates & Licenses N/A PHYSICAL DEMANDS None WORK ENVIRONMENT - Modern office suite in high rise building in downtown Chicago. Flexible hours, ability to work from home upon tenure requirements and approval from manager.

Supervisor Repricing

Allied Benefit Systems

Posted 2 months ago

Registered Nurse PM

Universal Health Services

Posted 3 weeks ago

VIEW JOBS Responsibilities Hartgrove Behavioral Health System is a 160-bed leading psychiatric hospital dedicated to providing quality behavioral health services for its diverse population of children, adolescents and adults. Hartgrove Hospital has become the flagship behavioral health facility within Universal Health Services, Inc., its parent company. As a leader in behavioral health within UHS and in the Chicago area, Hartgrove Hospital is a state-of-the-art facility offering some of the most advanced technologies and programs found in the behavioral health field. We are dedicated to our teamwork approach and provide a compassionate and therapeutic environment, as well as offering a continuum of specialty programs throughout our inpatient, partial and outpatient services. Hartgrove is a Joint Commission approved and state licensed facility focused on short-term crisis stabilization programs. We provide fully accredited educational programs, comprehensive Activity Therapy, Pet Assisted Therapy, Art Therapy, Horticultural Therapy and Dance Movement while utilizing a holistic treatment approach. * Hartgrove Behavioral Health System is first hospital in the nation to receive the Joint Commission Gold Seal of Approval for Trauma-Informed Care and Neuropsychiatry!* Ranked as one of the "Top 100 Best Psychiatric Hospitals in the Country" by US News & World Report The Registered Nurse provides professional nursing care on a designated unit in a manner consistent with the philosophy and objectives of Hartgrove Hospital. The Registered Nurse prescribes, coordinates and delegates nursing care utilizing the nursing process which is integrated into the multidisciplinary treatment team plan of care. The Registered Nurse is accountable for assigned nursing care activities on a shift basis and is responsible for promoting and enhancing professional nursing practice on the unit. The Registered Nurse is authorized to initiate restraints or seclusion and assess continuation. The Registered Nurse also assumes Charge Nurse responsibilities as required. Qualifications JOB SPECIFICATIONS: To perform this job successfully, an individual must be able to demonstrate competency in the criteria listed in this job description. The specifications listed below are representative of the knowledge, skill, and ability to meet the minimum requirements for this position. Staff must demonstrate flexibility for reassignment to units providing care to varied populations including children, adolescents, and adults. Education: Graduate of nursing program. Experience: One-year prior psychiatric experience in mental health nursing preferred. Licensure/Certification: Licensed as a Registered Nurse in the State of Illinois Knowledge: Must possess knowledge of general and psychiatric nursing processes, therapeutic relationships and processes, age specific growth and development, limit setting, crisis and behavior management, restraint and seclusion procedures and criteria and CPR training. Supervision Received: Nurse Manager, Nursing Supervisor, Director of Nursing and Asst. Director of Nursing Supervision Exercised: MHW, MHS, PS, LPN Line of Promotion: From this position: Nursing Supervisor To this position: Entry Level Environmental Conditions: Exposure to psychiatric patients who may exhibit violent/aggressive behavior. Potential for exposure to communicable diseases, blood/body fluids and other hazardous waste. General hospital environment. Physical Requirements: Ability to communicate verbally and in writing. Physical agility to manage patients with crisis prevention interventions. Push, pull and lift up to 40 pounds. Intermittent sitting, standing, walking, bending and stooping. The physical requirements described here are representative of those that must be met by an employee to successfully perform the functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the primary functions. Job Classification: Non-Exempt; Hours vary based on staffing needs and include day, evening, night and weekend shifts. This job description in no way states or implies that these are the only duties to be performed by this employee. The Registered Nurse will be required to follow any other instructions and to perform any other duties requested by the Head Nurse, Nurse Manager, Nursing Supervisor. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.

Apply