Overview
Opens, sorts and distributes incoming mail via electronic workflow system for the Benefits department. Applies the correct indexing schema to each document, assigning member number, name, document type and workflow folder. Associate must make decisions on a daily basis and select most appropriate document type and workflow folder for uncommon documents based on reading the content. Creates and maintains all healthcare provider records in the Facets claim processing system. Associate must make decisions on a daily basis to match existing provider records or to create a new record. Discretion is given to the associate to select the correct place of service, specialty, type and provider credentialing from three or more source references. The objective is to build a complete accurate record using multiple source documents of varying quality. Assigns user warning workflow messages for proper routing and plan coverage. Associate must be flexible and appropriately shift priorities several times each week based on the volume of mail and Facets new providers. Works with minimal supervision and is responsible for making an established range of decisions, escalating to Manager when necessary and updating Manager on a regular basis.
What you will do:
Qualifications:
Western & Southern Financial Group
06/01/2024
Cincinnati,OH