Reimbursement Data Enty Representative

hace 1 día

Heredia, Costa Rica SGF Global A tiempo completo

_SGF Global is a global leader with over 30 years of experience providing recruitment solutions. We are hiring a Sales/Executive Agent to work with a destination management company for Chile. You will manage B2B accounts recommending, booking, and managing incredible travel experiences for clients. Offering tourism-related services and package excursions will help us to maintain our clients delighted._

**Role Overview**:
This role will support the company in achieving its mission to connect patients, providers, and payors to ensure patients can access best-in-class technologies and products. The Reimbursement Data Entry Representative is responsible for processing incoming insurance verification requests and related communication. The data entry representative will be responsible for data quality and integrity of information transcribed into the dedicated database. The data entry representative will also be responsible to provide best in class customer service support for all outbound provider communication, inbound calls, and may include triage and case escalation as appropriate. The data entry representative will be required to follow company policies, procedures, and compliance directives at all times. This role will be required to ensure all protected health information (PHI) is managed appropriately within the governing Health Insurance Portability and Accountability Act (HIPAA) guidelines.

**Responsibilities**:

- (30%) Review of all assigned incoming faxes received daily and further compiling, sorting, and establishing data entry priorities, including identifying missing information and missing information resolution.
- (20%) Review all data entry related work for accuracy and completeness as quality will be a paramount component of this role, including protection of PHI.
- (10%) Reports any delays/challenges and escalates complaints accordingly to Team Lead and/or Supervisor as necessary.
- (10%) Performs related duties as assigned.

**Location**:
With start out as a remote employee due to impact of the Covid-19 pandemic, but will slowly transition to work in our offices as time goes by.

**Education**:
Required
- Work experience or education in a healthcare related, life sciences, or quantitative field (Medicine, Nursing, Biology, Biochemistry, Engineering, Math, Finance/Accounting, or related)

Preferred
- Four year college degree
- Reimbursement and/or Healthcare admissions/Intake experience within the healthcare industry

**Licenses/ Certifications**:
N/A

**Experience**:

- 1-3 years’ experience required in customer service, healthcare admissions/intake, and/or reimbursement experience within the biotechnology, pharmaceutical or Durable Medical Equipment (DME) industry
- Knowledge of Medicare, Medicaid, and Private Insurance Reimbursement Methodology
- Previous coding and billing experience in the healthcare industry - preferred, but not required
- Intermediate knowledge of Microsoft based products/Office Suite (Word, Excel, Outlook, Skype, TEAMS, etc.)
- Basic understanding of Data Entry/Customer Relationship Management programs (SalesForce, Dynamics365, other)
- Familiar with ICD 10 Coding

**Competences**:

- Exceptional Customer Service skills that align with Smith and Nephews best in class culture
- Strong attention to quality and details in adherence to standards while ethically maintaining a business perspective
- Strong work ethics and holds self accountable with willingness to learn, and desire to continually improve
- Ability to consistently interact professionally at multiple levels within a client-oriented organization
- Possesses effective communication skills, oral, written, listening, and non-verbal
- Excellent organizational and time management skills
- Displays strong critical thinking skills
- Flexibility and adaptability to change according to business needs
- Able to handle high volume case situations and maintain a positive attitude in a fast-paced environment

**Physical Demands**:

- Employee is regularly required to stand, sit, talk, hear/listen, and use hands and fingers to operate a computer and telephone keyboard
- Close vision requirements due to computer work
- Light to moderate lifting required, example: Using the in-office printer and refilling paper trays/toner

**Travel Requirements**: Up to 10%

Tipo de puesto: Tiempo completo, Temporal
Duración del contrato: 3 meses

Educación:

- Licenciatura terminada (Deseable)

Experiência:

- Health Care Customer Service: 1 año (Obligatorio)

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