Third Party Research Specialist -

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POST DATE 9/12/2016
END DATE 10/24/2016

AppleOne Raleigh, NC

Company
AppleOne
Job Classification
Full Time
Company Ref #
23179377.11502411
AJE Ref #
576147743
Location
Raleigh, NC
Job Type
Regular
Required Licenses/Certifications
df-aj

JOB DESCRIPTION

APPLY
This Third Party Research Specialist Position Features:

Job Summary: Responsible for researching and verifying Third Party Liability insurance and updates the state MMIS system.

Main Duties and Responsibilities:
? Researches and verifies eligibility information via online lookups to carrier eligibility websites or by phone with various carriers and updates the state MMIS system.
? Loads a minimum of 20-25 adds per day into the state MMIS system and terminates existing TPL insurance policies.
? Answers incoming calls from providers, Medicaid recipients, and other entities in relation to private/commercial insurance.
? Maintains an accuracy of 99% or above on all work activities per contractual obligation with state.
? Performs other duties as assigned.

Additional Essential Functions:
? Ability to communicate both verbally and in writing, fluently in English.
? Ability to be careful and thorough.
? Ability to build relationships both in person and over the phone.
? Ability to work proficiently with company software used on the project (i.e. Microsoft Word, Excel, ImageNow, etc.).
? Ability to navigate various websites.
? Average manual dexterity in use of a PC, phone, sorting, filing and other office machines.
? Ability to sit and work at a computer for an extended period of time.
? Working knowledge of HIPAA privacy and security rules.
? Ability to organize well.
? Ability to perform well in team environment.
? Ability to work independently to meet objectives.
? Ability to meet deadlines.
? Develops effective working relationships with internal and external clients.
? Meets attendance guidelines.
? Adheres to corporate and office policies.
? Maintains an accuracy of 99% or above on all work activities-per contractual obligation with state.
? Proactively identify areas of improvements within daily work activities
? Gain general understanding of HMS and office operations

Minimum Education: High School Diploma or GED required; Associate?s degree preferred.

Minimum Related Work Experience:
? 1+ years experience in insurance verifications.
? Customer call center environment experience.
? Knowledge of state Medicaid systems. We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.

Job Experience:

, , ? 1+ years experience in insurance verifications.
? Customer call center environment experience.
? Knowledge of state Medicaid systems