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Senior Data Entry Clerk - San Antonio, TX more...
Location:San Antonio, TX
Company:OptumCare
First posted:June 15, 2017
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The Senior Data Coordinator is responsible for routine clerical functions to support daily operations within the Claims Department, thus contributing to a smooth workflow, and efficient processing of claims. This position will include responsibility of data entry of information included in standard medical claim forms (HCFA, UB04), invoices, and escalated claims into various databases. In addition, this position will handle all incoming and outgoing mail function to include distribution, documentation, counting, sorting and batching to our external vendors. This position will support the Claims department by consistently meeting quality and production goals in the processing of information.

Primary Responsibilities:

Accurately inputs claim batches and keys all pertinent information from claims documentation, (including all fields from HCFA and UB04 forms) and office fee tickets (including ICD9 codes, ICD 10 and CPT coding)

Verifies all data elements are available including member eligibility on claims prior to data entry

Analyzes claim rejections from clearing house, various error claim reports such as member reject reports etc. for data entry and or return to providers letters

Processes all incoming daily mail/correspondence to include, opening envelopes, date stamping of member mail with current receipt dates, verification of eligibility, opening of all mail, sorting out mail by market specific and/or provider specific

Routes claims for back end scanning to vendors, maintains departmental files, reports, and retrieval of documentation with vendors. Prepares documentation for older claim files for archiving with vendors and maintains log for future retrieval

Responsible for all faxes for routing to various departments and or scanning with our vendor

Meets and maintains quality and production goals related, but not limited to, phone calls, overpayments, unsolicited checks, appeals, TDI complaints and processing

Coordinates with the Claims Manager and/or Claims Supervisor on workflow issues and the handling of first in first out order to ensure turnaround times are met

Performs all other related duties as assigned

Required Qualifications:

High School Diploma or GED

Two to three years of administrative support experience, or working with database management, data entry or data management

Knowledge of Microsoft Office applications including Word, Excel, PowerPoint and Access

Knowledgeable of ICD-9, ICD-10 and CPT coding

Basic phone, filing and typing skills

Ability to lift up to 25 pounds

Ability to sit for extended periods of time

Ability to stand for extended periods of time

Ability to use fine motor skills to operate office equipment and/or machinery

Ability to receive and comprehend instructions verbally and/or in writing

Ability to use logical reasoning for simple and complex problem solving
Preferred Qualifications:

6 - 12 or more months of claims processes and or healthcare experience

6 - 12 months related experience in the healthcare industry
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Claims, data entry, eligibility, San Antonio, TX, Texas

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