Flex Claims Processor II

Competency Statement(s)
Accurate - Ability to perform work accurately and thoroughly
Communication, Oral - Ability to communicate effectively with others using the spoken word
Communication, Written - Ability to communicate in writing clearly and concisely
Customer Oriented - Ability to take care of the customers' needs while following company procedures
Interpersonal - Ability to get along well with a variety of personalities and individuals
Problem Solving - Ability to find a solution for or to deal proactively with work-related problems
Time Management - Ability to utilize the available time to organize and complete work within given deadlines
High School Graduate or General Education Degree (GED)
Previous experience in data processing preferred
10-key skills required
Superior customer service and phone skills
Must be able to work independently or with a team as well as work various shifts
Ability to quickly learn new technology
Must be able to understand and follow complex instructions
Ability to accurately type 35wpm
CB Job Description: LogistiCare is much more than just a transportation company. We organize and credential thousands of local transportation providers to serve specialized groups of people, who require all kinds of personal mobility solutions. LogistiCare provides coordination and oversight that makes a transportation program more effective and reliable for millions of people every year.
LogistiCare is currently seeking a Flexible Claims Processor II. The ideal candidate's skills and experience will align with the position description and requirements.
The Flex Claims Processor is responsible for verifying and processing transportation provider billing invoice forms in an accurate and timely manner. In addition, the Flex Claims Processor will work as a Customer Service Representative for eight hours each week, usually on Mondays. The allocation of hours between Claims Processing and CSR tasks will be determined by management and may vary. The Flex Claims Processor will be required to meet both claims and CSR production standards.
Process transportation provider billing invoice forms at a rate of 180 manual claims per hour or 540 Web Billing/Electronic claims per hour with a 98% minimum quality score. This is a 10% increase over the expectation of a Claims Processor. The standard for earning any incentive payment is 105% of the required production. The incentive program may be discontinued or changed at any time.
Work for 8 hours taking reservations. Focused on peak call-volume days, the Flex Claims Processor will be expected to be available every Monday. As such, the Flex Claims Processor can have no more than two attendance occurrences on Mondays in a calendar year. Attendance occurrences on Mondays will count double the normal policy, i.e. two occurrences for an absence and one occurrence for lateness . Time off is permitted on Mondays only if it is prescheduled and approved in advance by management.
Production standards while taking member reservations will be monitored by the supported call center and the Flex Claims Processor will be required to take calls at a rate of 90% of the standard applicable to full-time CSRs working the same contract(s). Allowances will be made for unexpected lulls in overall phone volume. The Flex Claims Processor will also be required to pass all call quality monitoring.
Up to twice a year, the Flex Claims Processor must attend a call reservation training course to be held outside normal business hours. This will be scheduled at least two weeks in advance, and the Flex Claims Processor will be paid for the time spent attending the training in accordance with LogistiCare and applicable law.
Process transportation provider billing invoice forms
Communicate with transportation providers when applicable
Identify and resolve problems with transportation provider billing invoice forms
Meet all departmental deadlines
Work closely with the Fraud and Abuse department
Adhere to and ensures all company policies and procedures are maintained
Performs other administrative duties as assigned
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