PPO Re-Pricer I

Job Description:

The PPO (Preferred Provider Organization) Re-pricer I will enter medical claims data into various network pricing platforms to obtain contractual pricing based on PPO network contracts. Supports the claims processors with network pricing. Works with network partners to review pricing methodologies or issues that may arise.

$10.18

Key Functions

• Meets minimum core competency for production of 30 claims per hour.
• Re-prices claims in an accurate and timely manner using network platforms.
• Provides accurate inventory and production counts as needed.
• Completes re-work projects in a timely and accurate manner.
• Performs other duties as assigned or needed
• Meets department and quality production standards. Achieves 95% TAT Resolution.
• Performs other duties as assigned or needed.

Experience and Skills:

• High school degree or equivalent.
• Ability to work efficiently and accurately.
• Ability to perform customer service tasks.
• Demonstrate Accuracy, Customer Service, Timely Turn-Around (ACT).
• Excellent verbal and written communication skills.
• Proficiency using Microsoft Office (Word, Outlook, Excel, etc.).
• Ability to work efficiently, perform multi-tasking, prioritize tasks, and meet tight deadlines.
• Possess a high degree of integrity and discretion, as well as the ability to adhere to both company policies and best practices.
• Able to demonstrate excellent attendance and punctuality by not being on action plan.
• Ensure compliance with security practices and procedures, including HIPAA and HITRUST standards.
• Protect and enhance the Core Purpose and the Core Values of AmeriBen.

Preferred Qualifications

• Types 45 wpm, 10-key by touch, computer knowledge.
• Working in high volume escalations.

AmeriBen is not yet hiring in the below states:

• Delaware, Massachusetts, Montana, New Hampshire, New York, North Dakota, Rhode Island, South Dakota, Vermont, District of Columbia and Puerto Rico.

AmeriBen is an Equal Opportunity/Affirmative Action Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com .