Operational Support Specialist is responsible for providing operational support to the Patient Accounts staff responding to requests for information or actions needed on a patient's account. Requests received from the Claims Specialists, Reimbursement/Coding Specialists, and Patient Accounts Managers and Leads.
Essential Job Functions
Scanning into Auto Silo
• Scans EOBs, charge tickets, correspondence, IHS purchase orders and patient prescriptions for services to eliminate paper and create an electronic copy that is easily retrievable.
• Indexing the document to ensure the batches are prepped appropriately to include batch types, numbered front and back, batch numbers and dates
• Perform audits to ensure checks/balances are in place to compare actual to final reports produced; rescanning anything that was missed prior to shredding originals.
• Indexes and scans into the appropriate project
• Validates and verifies each step in the process. Accuracy is critical as originals are shredded.
• Manages document shred schedule
Outgoing Mail
• Pulls secondary claims explanation of benefits (EOB) and claims out
• Reports if they see anything out of the ordinary to Management
• Understanding of what claims need to be sent as a priority
• Mails both primary and secondary claims out
Incoming Mail
• Sorts and opens all incoming mail from the mail clinic.
• Distributes mail within the Patient Finance Departments to include clinic, hospital and patient financial services
• Monitors and check fax machines and distributes as appropriate
EDI Claims
• Distributes daily claim runs to staff
• Sort the claims according to department, primary, secondary, auto-cross over claims
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