Exception Template
Description:
Position Title: Clinical - Exception Template
Work Location: Remote National
Assignment Duration: 6 months
Work Schedule: 8 am- 5 pm Monday - Friday, holidays included No OT
Work Arrangement: Remote National
Position Summary: Review claims of previously billed members to make sure they are billed correctly
Background & Context:
Medicare
Monthly Huddles
Team meetings
UM based retro recoupment
Additional workload to optimize performance
Key Responsibilities:
Review claims of previously billed members to make sure they are billed correctly
Create reports for incorrect billing for review by team members
Admin work
Fax letters to providers to request additional information
Organizing spreadsheets
Sorting and delivering mail
Charting of clinicals
Support project claims and inquires
Monitor rebilling
Qualification & Experience:
Required: High School or GED
Preferred: An Associate's Degree in a related field
Required: 1+ year of experience in Directly supporting clinicians
Must haves:
Nice to haves: TrueCare experience
Disqualifiers:
Performance indicators:
Top 3 must-have hard skills
Level of experience with each
Stack-ranked by importance
Candidate Review & Selection
1 Organized
2 Excel
3 Front Desk office experience
Candidate Requirements
Education/Certification
Required: High School or GED
Preferred: An Associate's Degree in a related field
Licensure
Required: 1+ year of experience in Directly supporting clinicians
Preferred:
Years of experience required
Disqualifiers
Best vs. average
Performance indicators
Must haves:
Nice to haves: TrueCare experience
Disqualifiers:
Performance indicators:
Top 3 must-have hard skills
Level of experience with each
Stack-ranked by importance
Candidate Review & Selection
1
Organized
2
Excel
3
Front Desk office experience