Job description
Operations Support Coordinator
Position Summary:
The Operations Support Coordinator acts as a resource for the Operational team in the support and development of a variety of cross-functional support services which includes but not limited to reporting, data evaluation to accurately enter data into core system/surround code, distribution of operational support data, claim error resolution, and review of source documentation to accurately route and record. Supports the elements in the organization that are consistent with meeting/exceeding the expectations of our customers as defined in our mission statement.
Position Responsibilities:
- Support aspects of operational reporting generation, review, and development according to defined parameters and frequency.
- Research and respond to internal customer referrals and inquiries as necessary.
- Support resolution to defined claim types to allow for successful load into core system.
- Evaluate data received from a variety of internal and external customers to capture key elements into our core adjudication system.
- Provide support to Adjustments Teams in aspects of reporting and defined support processes.
- Support review of incoming pre-determinations requests for accurate recording and routing.
- Support operational team for miscellaneous support
- Provide testing/research support related to special projects initiated through business improvement initiatives
- Maintain and develop documentation for all operational support policy and procedures
- Seek to determine areas for workflow improvement by evaluating all source material and offer recommendations for improvement opportunities
- Support review and document the SPD language into Bridge notes.
- Supports Bundle Bill processing for the back-office product
- Other duties as assigned
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this
job. Duties, responsibilities, and activities may change at any time with or without notice.
Position Qualifications:
Required
- HS Diploma or equivalent experience
Preferred
- Minimum of 1 year experience in TPA or healthcare industry preferred.
Skills, Knowledge, and Abilities
- Initiative to learn Third Party Administration concepts and philosophies
- Excellent oral and written communication skills
- Exceptional customer service, and interpersonal skills
- Effective problem-solving and influencing skills
- Strong organizational, self-motivation, and decision-making skills
- Proficiency using Microsoft programs (Word, Excel, PowerPoint)
- Ability to manage multiple priorities in a fast-paced environment
- Ability to work independently and collaboratively, as needed
Key Competencies:
- Service orientation
- Integrity
- Ethical practice and confidentiality
- Successfully maintain accuracy
- Successfully maintain turnaround expectations
MedCost provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
MedCost participates in the Electronic Verification system (E-Verify) to electronically verify the work authorization of newly-hired employees. E-Verify is an internet-based program that compares information from an employee's Form I-9 to data contained in the federal records of the Social Security Administration and the Department of Homeland Security to confirm employment eligibility. MedCost does not use E-Verify to pre-screen job applicants.
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