University Medical Center of El Paso
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Prov. Care Unit Rep, EPH
at University Medical Center of El Paso
Assigned to answer all provider claim resolution calls and adjudicate claims for providers on demand. Must have knowledge of the Medicaid and Correct Coding Guidelines in order to process high level claim resolution calls. Interact with various departments within the health plan and requires a pleasant personality.
1. Knowledge of medical terminology preferred.
2. Knowledge of 10 key calculator.
3. Able to work in fast-paced office, handle a high volume of provider calls, and handle frequent interruptions.
4. Ability to professionally address claims issues with other departments and/or providers.
5. Ability to handle high volume of provider telephone calls.
6. Ability to work independently and manage time effectively.
A. Work Experience
Two years coding experience with CPT-4, HCPCS, and ICD-9 diagnostic coding; familiarity with State of Texas local coding guidelines and Corrective Coding guidelines required. Experience preferred with CCS-P, CPC-H, CPC-P, CEMC, CPMA OR CCS or equivalent credentials. Claims processing and adjudicating or medical billing experience is desired.
CPT Coding Certification preferred.
C. Education and Training
High school graduate or equivalent. Completion of a formal Insurance Processor program preferred.