Adjudication Representative-ADJR

Company: LogistiCare
Location: Tempe
Posted on: September 13, 2020

Job Description:

The Adjudication Representative is responsible for pre-billing, patient account billing, and patient account collections. This job involves heavy computer use and public telephone contact. Essential Duties & Responsibilities: - Determine if claim should be billed to 3rd party payer or as a private pay - Verify eligibility and covered benefits with insurers for all provider claims for non-contracted transports or for contracted transports not verified by the call center - Identify provider claims that should be questioned for Coordination of Benefits - Check accuracy of charges submitted for payment including fee schedule type, diagnosis, mileage, supplies and appropriate level of service - Obtain billing authorizations, when required, for all non-contracted transports or contracted transports not previously obtained from the call center - Enter claims into Logisticad (Logisticare's proprietary software) that fall outside of the normal process - Obtain correct billing address information - Determine potential MRU claims - Other duties as assigned Note: This description is not intended to be all-inclusive. Employee may be requested to perform other duties from time to time. REQUIREMENTS Education: -Qualified candidates must have a High School diploma or have a General Education Degree (GED) Experience: - Prior insurance or billing experience in medical environment preferred - Prior book-keeping experience or claims processing experience preferred - Prior customer service experience preferred - Prior collections experience preferred Skills: - Experience using internet search tools and Microsoft Office - Excellent oral and written communication skills Competencies: - Communication, Oral - Ability to communicate effectively with others using the spoken word - Interpersonal - Ability to get along well with a variety of personalities and individuals - Detail Oriented - Ability to pay attention to the minute details of a project or task - Organized - Possessing the trait of being organized or following a systematic method of performing a task - Time Management - Ability to utilize the available time to organize and complete work within given deadlines Environmental and Working Conditions: -Entire work time is conducted in an office setting. Physical and Mental Requirements: -Ability to work independently or with a team a must LogistiCare is an equal opportunity employer. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Keywords: LogistiCare, Tempe , Adjudication Representative-ADJR, Other , Tempe, Arizona