- Process Code: 05259
- Work Station Assignment: TBD
Responsible for ensuring proper processing of information from first line of process to identify and reconcile possible adjustments.
Responsibilities
- Information Review
- Processes client information by adheres to the standard operating procedures (SOP) and turnaround time set forth
- Reviews and identifies if there are adjustments and variances to reconcile
- Summarizes information to prepare necessary reports
- Liaises with other processors to reconcile any issues regarding client information
- Business Process Support
- Resolves issues and other inquiries regarding matters of work in a customer-oriented approach
- Ensures proper file management for all client systems by accurate and complete documentation
- Routes tasks to appropriate processors by utilizing internal systems
- Refers matters beyond limits of authority and expertise to immediate superior for direction
- Upholds the Crawford Code of Conduct by protecting the confidentiality of information
- Performs variety of administrative duties and other related tasks from time to time as assigned to contribute to other business processes
- Non-clinical staff may not conduct any activities that require interpretation of clinical information, including but not limited to, the choosing of a set of criteria to use for handling a request for healthcare services or treatments.
Qualifications
- Bachelor's degree in any related course.
- At least two (2) years working experience in a claims or insurance management services.
- Proficient typing skills.
- Good communication skills.
- Proficient in word processing and spreadsheet softwares.
- Analytical skills - Identify and evaluate information.
- Ability to multi-task, prioritize and manage time effectively.
- Keen attention to details in order to produce quality output.
- Maintains high degree of professionalism and confidentiality.
- Interpersonal skills - Able to work independently and as a team member.
