Conduent Reimbursement Specialist in Somerset, New Jersey
Conduent is the world's largest provider of diversified business process services with leading capabilities in transaction processing, automation, analytics and constituent experience. We work with both government and commercial customers in assisting them to deliver quality services to the people they serve.
We manage interactions with patients and the insured for a significant portion of the U.S. healthcare industry. We are the customer interface for large segments of the technology industry and the operational and processing partner of choice for public transportation systems around the world.
Whether it's digital payments, claims processing, benefit administration, automated tolling, customer care or distributed learning - Conduent manages and modernizes these interactions to create value for both our clients and their constituents. Learn more at www.conduent.com .
Responsible for providing professional and analytical support to medical services programs, including implementation, operation and contract compliance (e.g., Medicare); Utilization Review; Condition Management; Health Care Coordination; Case Management; Insurance Claim Administration; Pharmacy Services; Medical Services; Collection Services; Negotiates liability settlement of medical claims with third parties or healthcare providers; seeks reimbursement from healthcare providers and/or ensures payment of claims by appropriate insurance carrier.
Insurance:Provides administrative support to the claim processing function.
Eligibility: Position is responsible for gathering information related to applications for public assistance programs.
Patient Accounting Specialist: Provides administrative support to the hospital billing department.
Senior level job with considerable work experience
Has developed specialized skills or is multi-skilled through job-related training
Completes a variety of atypical assignments
May solve problems of a recurring nature, but takes a broad perspective to problems and may identify new, less obvious solutions
Completes work with a limited degree of supervision
Acts as an informal resource for colleagues with less experience
May lead a team in the performance of a variety of tasks that are generally routine
May have specialized external certification (technical roles)
Insurance Job roles may perform one or more of the following:
Researches unpaid and denied claims to determine course of action.
Checks the accuracy and completion of routine and complex claim forms.
Maintains employee benefits records.
Eligibility roles may perform one or more of the following:
Reviewing applications submitted.
Identifying required client data.
Verifying data in support of the public assistance eligibility determination.
Communicating with clients.
Reviewing case information and preparing it for case disposition by the state eligibility consultant.
Patient billing roles may perform one or more of the following:
Performs analyses and manages the day-to-day operations of the billing process.
Reviews and analyses each billing cycle to ensure accuracy.
Researches billing issues. Responds to telephone inquiries and complaints.
Obtains supporting documentation when needed.
All other duties as assigned.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form at https://downloads.conduent.com/content/usa/en/file/conduent-applicant-adaaa-referral-form.pdf .
Job Service Delivery Healthcare
Primary Location United States-New Jersey-Somerset
Organization Financial Service Healthcare
Unposting Date Ongoing
Req ID: 18020740