ABR EMPLOYMENT SERVICES Customer Service Representativie in SCHOFIELD, Wisconsin
JOB REQUIREMENTS: Process and develop VAPCCC (Veterans Administration Patient-Centered Community Care) claims for missing information in accordance with VA regulations and guidelines. Present a favorable corporate image while responding to all inquiries (including Prime) within the time frames required exceeding all contractual standards. -Correct payment errors on a post-processing basis, including edit resolution, credits, additional payments, statistical adjustments and recoupments. -Respond to inquiries from the VA or other groups regarding Veterans eligibility, benefit determinations and claims adjudication questions or problems. -Analyze claims to determine if eligibility requirements and claim filing requirements are met and make determinations. -Add development information to claims. -Maintain integrity of claim auditing system by identifying and reporting potential system problems; provide examples and documentation to support findings. -Process adjustments according to VA policy by making an additional payment, reissue or statistical adjustment. -Request recoupment of payments in accordance with VA policy. -Respond to telephone, written, fax and e-mail inquiries concerning VA eligibility, benefits determinations and claims adjudication, maintaining rapport with all contacts and exceeding contractual standards. -Obtain and analyze claims data to determine the specific problem area including external communication to obtain data. Complete research and provide final resolution to inquiries within contractual requirements. -Communicate with the Prime to determine appropriate authorization or referral of services. -Educate providers on the billing requirements of VA to reduce claim issues. -Deal tactfully with people in a wide variety of situations to convey a favorable corporate image. AA/EOE #sayestoABR ***** OTHER EXPERIENCE AND QUALIFICATIONS: Qualifications for the Customer Service Representative Two (2) years customer service experience in Insurance or related industry * Recent working knowledge of Facets System applications * Ability to learn and apply VA benefits, policy, and federal regulations * Ability to learn all VA claims processing methodologies and systems Preferred: Knowledge of medical terminology, Current Procedural Terminology (CPT), and International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes Education Required High school diploma or equivalent Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities ***** APPLICATION INSTRUCTIONS: Apply In Person: ABR Employment Services 1521 Metro Dr., Ste. 204 Schofield, WI Mail a Rsum: ABR Employment Services 1521 Metro Dr., Ste. 204 Schofield, WI 54476 E-Mail a Rsum: email@example.com Apply Online: www.abrjobs.com Fax a Rsum: 715-355-4486 Call For Appointment: 715-355-7711 Other: Affirmative Action/Equal Opportunity Employer (AA/EOE) This position is listed by a private employment agency. The agency is the legal employer. No fee will be charged of the job applicant.