Job Title: Medical Claims Coordinator

Location: Austin, TX

Job Type: Full-Time

Work Arrangement: Remote

Company Overview: At Soluta-Boon-Chapman, Prime Dx a dynamic and innovative software and TPA organization, we are dedicated to delivering cutting-edge solutions to our clients. As we continue to expand and evolve, we recognize the critical role of human resources in driving our success. To strengthen our capabilities and ensure alignment with our strategic goals, we are seeking a highly skilled and experienced Medical Claims Coordinator to join our team.

Position Overview: As the Medical Claims Coordinator, you will play a pivotal role in managing and overseeing our claims processes to ensure efficiency and accuracy. Reporting directly to the Claims Manager, you will be responsible for handling various administrative tasks related to claims processing, including registering claims for adjudication, monitoring internal systems for high-priority tasks, and routing tickets to the appropriate departments. Additionally, you will assist in document management, special projects, and other duties as assigned. This role requires strong organizational skills, attention to detail, and the ability to adapt to a constantly changing environment

Benefits:

• Competitive salary

• Comprehensive health, dental, and vision insurance

• Retirement savings plan with company match

• Paid time off and holidays

• Professional development opportunities

Task Management and Prioritization:

• Monitor the internal ticket system for high-priority tasks.
• Notify the appropriate party regarding urgent matters.
• Route tickets to the correct contact or department for resolution.

Claims Processing:

• Register claims in preparation for adjudication.
• Add and index documents in Vasion-Add for efficient record-keeping and retrieval.

Administrative Support:

• Perform special projects as assigned by the Claims Manager.
• Complete other duties as assigned to support the smooth operation of the claims department.

Skills Required:

Organizational Skills:

• Efficiently manage and prioritize tasks to meet deadlines.
• Maintain accurate records and documentation.

Communication Skills:

• Strong interpersonal skills for effective collaboration with team members and external contacts.
• Clear written communication for documentation and correspondence.

Technical Proficiency:

• Familiarity with standard office operating equipment, including the Eldorado Claims System (A Plus!) and various Microsoft Office applications.

Attention to Detail:

• Ensure accuracy in claim registration and documentation.
• Conduct thorough review of claims data and reports.

Problem-Solving Ability:

• Identify and resolve issues in claims processing efficiently.
• Analyze information to make informed decisions.

Adaptability:

• Ability to adjust to changing priorities and procedures in a dynamic environment.

Time Management:

•  Manage workload effectively to meet deadlines and performance goals.

Confidentiality:

• Maintain strict confidentiality of sensitive information and patient data.

Professionalism:

• Maintain a professional appearance and demeanor.
• Demonstrate a commitment to maintaining confidentiality and upholding ethical standards.

Teamwork:

• Collaborate effectively with colleagues to achieve departmental goals and objectives.

Qualifications:

• High School diploma or equivalent. Experience and education may be substituted for one another.
• 1-2 years of office/clerical experience.
• Knowledge of professional customer service practices.
• Typing speed of 50 WPM, 7,000 KPH, and efficient use of 10-Key.
• Ability to work independently and as part of a team.

Work Environment / Physical Requirements:

• Prolonged periods sitting at a desk and working on a computer.

• Must be able to lift up to 15 pounds at times.

Soluta and Boon-Chapman is an equal opportunity employer committed to diversity and inclusion. We encourage qualified individuals from all backgrounds to apply.

DISCLAIMER

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.