About this role
Role Overview
- Support regulatory reporting, research, and compliance data management
- Collect, organize, and analyze workers’ compensation data
- Assist in the completion of data calls or targeted audits
- Document and maintain workflows and procedures on EDI reporting
- Maintain knowledge of policies, procedures, and reporting operations
- Provide subject matter expertise in FROI/SROI and Medicare Section 111 reporting
- Comply with regulatory requirements and company rules
- Assist with special projects assigned by management
- Analyze EDI data to identify areas of non-compliance
- Complete various forms of transactional tracking to ensure efficiency, timeliness, and accuracy of reporting
- Support Medicare Secondary Payer Act processes
- Distribute reports to management according to department procedures
- Identify opportunities for continuous improvement
Requirements
- High school diploma or GED required;
- 2+ years’ claims insurance (or closely related) experience required.
- Good familiarity with claims electronic data interchange (EDI) is highly desired.
- Must be proficient in Microsoft Office (Excel, Word, PowerPoint and Outlook).
- Intermediate to advanced data entry skills with the ability to learn enterprise and department specific applications.
- Good understanding of insurance claims principles and practices.
Benefits
- Generous medical, dental, and vision plans
- 401K retirement plans and company match
- Bonus potential for all positions
- Paid Time Off
- Paid holidays throughout the calendar year
- Professional development support