Verification Processor

Description

Provide for ensuring accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.

Responsibilities:

• Update data into the Amisys system accurately and efficiently.
• Verify and correct as necessary claims received through the FormWorks process to include but not be limited to - Individual characters and fields in OCRepair and OCRepCrit, Information contained in KE (Key Entry).
• Complete UB's and HCFA's in FormWorks for claims unable to process directly via OCR (KFI/Key From Image).
• Notify the supervisor and/or team leader of any issues that my compromise client satisfaction.
• Verify electronically received data pre-adjudication.
• Investigate via Filenet software or EDI (Electronic Data Interchange) Inquiry Screen(s) any flagged claims.
• Claim hold/Batch error correction
• Search continuously for improvement opportunities and notifies the supervisor and/or team leader of trends.
• Maintain a thorough working knowledge of processes for electronically received data;

Qualifications

• Completion of High school diploma or equivalent.
• Able to use a QWERTY keyboard;
• Knowledge of Insurance, Managed Care, or Benefits Administration environment preferred;
• Prefer competency in MS Office and PC skills.
• Able to demonstrate organizational, interpersonal, and communication skills.
• Maintain designated production and quality standards required.
• Previous mailroom experience is preferred.