DESCRIPTION SUMMARY: Examines and evaluates service provider invoices to determine validity. Interprets and applies business rules in order to manage and reduce claims costs. Corresponds with service providers via mail, phone and Internet regarding any processing issues.
- Reviews submitted invoices and compares to published service provider rates, using mileage software and business rules in order to determine acceptance or rejection of payment on claim prior to processing.
- Understands and interprets reject reasons and applies appropriately to service provider invoices.
- Utilizes processing system to research all claims issues.
- May authorize stop pay and re-issue of checks to service providers.
- Researches incorrect purchase orders on service provider claims to determine validity of claim.
- Corrects documentation to reflect actual service provider utilized during customer service call.
- Completes additional duties as assigned.
EDUCATION: High School diploma/G.E.D or equivalent work experience
EXPERIENCE: 0 to 1 year related experience. Data entry experience and a customer service background required. Previous claims or related experience a plus.
COMPLEXITY: Possesses good attention to detail and problem solving skills. Demonstrates basic computer and typing ability. Utilizes organizational and interpersonal skills.
WORKING RELATIONSHIPS: Communicates with associates, customers, clients and management effectively and professionally.
ADDITIONAL REQUIREMENTS: Ability to work flexible schedule as business needs dictate.