Claims Accounting Banking Tech Temporary

Under the direction of the Claims Accounting Supervisor, this position will be responsible for all activities that relate to bank transactions including but not limited to; deposit reconciliation, researching returned checks, and reconciliation of daily reports.
Essential Functions:
Daily activities include reconciliation of Alegeus and Corresponding Claim Activity including daily audit of EOB, EOP, and SOR. Daily responsibilities require secure access to banking systems to research affidavit of forgery, match pay, and bank fraud. Prepares documentation for review by Supervisor or Manager.
Retrieval of daily deposit transmission reports with the purpose of reconciliation, review and batching refund checks. Perform a quality review of claim, EOB, and cash receipts to determine final disposition in claim System.
Researches member/provider inquires initiated by CEP, Chats, Alegeus, and e-mails.
Researches and reissues checks associated with returned/canceled/lost/reissued Kaiser Permanente checks in compliance with NCQA stand of review for all checks received. Accurate and complete research, recording of returned in conjunction with recovery activities, and in accordance with Unclaimed Property, Vendor Accounting&Check Receipts. Quality review of claim and/or pre-authorization data element submitted on claims/bills/pre-authorization against data applied to the QCARE and Xcelys Systems in compliance with NCQA stand of review for all checks received. Process the necessary steps required in adjusting or voiding the check and the claim. Calls members/providers contact for any additional documentation needed.
Advise configuration department about provider and member address changes.
Basic Qualifications:
Five (5) years of experience processing medical claims including POS, PPO, HMO, Medicare, Deductible & Coinsurance of which two (2) years would be in research and/or adjustments.
Experience must be on an automated system, including preparation of payments for medical bills, using medical terminology, CPT, ICD-9, ICD-10 and UB92 coding for both Medicare and non-Medicare claims, and working knowledge of other insurance benefit plans including coordination of benefits, no-fault and workers compensation, accumulation and cost sharing.
AA degree in accounting, business, or related field OR two (2) years of experience in a directly related field required.
High School Education OR General Education Development Diploma (GED) required.
License, Certification, Registration
Additional Requirements:
Effective communication skills required.
Must have a thorough understanding of all aspects of medical claims processing.
Must be able to review the work of others and provide feedback.
Personal computer terminal skills; including data manipulation and extraction skills.
Must pass Basic Excel test with at least 70% accuracy.
Must pass Basic Microsoft Access Database test with at least 70% accuracy.
Must be able to work in a Labor Management Partnership environment.
Demonstrated customer service skills, customer focus abilities, and the ability to understand Kaiser Permanente customer needs.
Preferred Qualifications:
Bachelor's degree preferred.

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