Public Consulting Group

Claims Specialist 1

Job Locations US-NH-Portsmouth
Posted Date 1 week ago(9/13/2021 4:38 PM)
Job ID
2021-7066
# of Openings
3
Category
Customer Service/Support
Type
Regular Full-Time
Practice Area
Health Services

Overview

About Public Consulting Group

 

Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Health practice offers in-depth programmatic knowledge and regulatory expertise to help state and municipal health agencies respond to regulatory change, improve access to health care, maximize program revenue, improve business processes, and achieve regulatory compliance. Using industry best practices, PCG’s Health team helps organizations deliver quality services with constrained resources to promote improved client outcomes. To learn more, visit http://www.publicconsultinggroup.com/health/.

Responsibilities

Responsibilities:

  • Process Professional and Hospital claims accurately and timely within claiming system
  • Process claims according to set guidelines for payment or denial
  • Price claims according to Medicare, Medicaid and custom fee schedules
  • Meet personal and team goals and metrics
  • Manually enter data from CMS1500 and UB04 claims into claiming system as necessary
  • Use available resources to manage workload
  • Actively participate in staff meetings
  • Communicate with supervisor on workload/issues/backlog
  • Follow procedures, guidelines and policies
  • Provide customer support for a 1-800 line inquiries as needed
  • Assist with other duties as assigned

 

Qualifications

Qualifications:

 

  • Proficient in Microsoft applications; particularly Word, Outlook and Excel
  • Ability to understand and use all systems required to perform duties, using dual screens
  • Ability to take initiative, prioritize tasks and manage workflow to meet deadlines
  • Ability to interpret, comprehend and follow policies and plan provisions
  • Excellent interpersonal skills
  • Excellent oral and written communication skills
  • Problem solving and analytical skills
  • Demonstrated typing skills and accuracy rate
  • Ability to work autonomously and within a team

Education:

  • HIgh School degree or equivalent

Eperience:

 

  • Experience working in claims or healthcare environment as well as customer Service Call Center or Customer Facing positions
  • Basic understanding of medical coding guidelines and medical terminology preferred
  • Basic understanding of healthcare and claims concepts preferred

 

EEO Statement

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

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