Encounter Reconciliation Expert

3 weeks ago


Los Angeles, California, United States MedPOINT Management Full time
About the Role

We are looking for a highly skilled Encounter Reconciliation Expert to join our team at MedPOINT Management. This role requires strong analytical and problem-solving skills, with the ability to work independently in a fast-paced environment.

The estimated salary for this position is around $65,000 per annum, based on industry standards and the company's location.

Job Description

The successful candidate will be responsible for reviewing and correcting incurred encounter rejections reported by various clearinghouses and health plans. This will involve working under the direction of the Team Lead and Supervisor, reporting, coordinating, and documenting new errors as they arise.

Key Duties and Responsibilities

  • Daily corrections of rejected encounters while following CMS and DHCS guidelines and meeting health plan turnaround time requirements.
  • Analyze rejected encounters trends and advise department team Leadership.
  • Health Plan reconciliation and projects.
  • Attend meetings (weekly team huddles, team building, etc.), as directed by team leadership.
  • Create and maintain an encounter error library.
  • Review and assist with creation of encounter reject standard operating procedures.
  • Perform other duties and special projects as directed by team leadership.

Qualifications

  • High School Diploma (bachelor's degree preferred).
  • Encounter clearinghouse knowledge highly preferred.
  • Knowledge in EZ-CAP preferred, but not required.
  • At least two years of Claims processing experience preferred.
  • Understanding of the managed health care industry.
  • High level knowledge of various health plan operations.
  • Proficiency in MS Office suite of products (Excel, Word, PowerPoint, Outlook).

Benefits and Salary

As a valued member of the MedPOINT Management team, you can expect a competitive salary package, including benefits such as health insurance, retirement plans, and paid time off.



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