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Technical Information Specialist
Palmetto GBA. Maintain records and process claims in medical review.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims processing, including troubleshooting and analyzing claims denials, while maintaining accurate records and ensuring compliance with confidentiality standards. Proficient in Microsoft Office and possesses strong analytical and communication skills to effectively support provider inquiries.
Highest-signal resume keywords
Claims ProcessingAnalytical SkillsMicrosoft Office ProficiencyCustomer Service SkillsConfidentiality Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims KnowledgeQuality ControlRecord MaintenanceTroubleshootingAdjustment Claims Processing
Soft Skills
Organizational SkillsVerbal Communication SkillsWritten Communication SkillsGood Judgment Skills
Tools & Technologies
Word Processing SoftwareFISS
Industry Keywords
MedicareClaims DenialsAdministrative SupportClerical Support
About the role
Key responsibilities & impact- Maintain records and process claims in medical review.
- Process ingoing and outgoing mail and prepare work for nursing staff.
- Troubleshoot claims before and after nurse review.
- Monitor claims-processing timeliness and adjust incorrectly keyed claims.
- Process claim denials and adjustment claims for pre-pay and post-pay departments.
- Investigate and analyze adjustment claim history and denial records.
- Prescreen records for review and maintain accurate claim records.
- Communicate with providers and assist the provider service department with inquiries.
- Generate educational correspondence to providers regarding denials.
- Perform quality control of work processes.
- Assist the manager with special projects.
- Work onsite Monday-Friday, 8:00-4:30, with minimal phone contact.
Requirements
What you’ll need- Associate's degree, or 2 years job related work experience as a degree equivalency.
- 1 year administrative/clerical support experience.
- Working knowledge of word processing software.
- Strong analytical, organizational, and customer service skills.
- Strong verbal and written communication skills.
- Proficiency in spelling, punctuation, and grammar skills.
- Good judgment skills.
- Ability to handle confidential or sensitive information with discretion.
- Microsoft Office proficiency.
- FISS experience preferred.
- Medicare experience preferred.
- Claims knowledge preferred.
Benefits
Comp & perks- 401(k) retirement savings plan with company match.
- Subsidized health plans and free vision coverage.
- Life insurance.
- Paid annual leave – the longer you work here, the more you earn.
- Nine paid holidays.
- On-site cafeterias and fitness centers in major locations.
- Wellness programs and healthy lifestyle premium discount.
- Tuition assistance.
- Service recognition.
- Incentive Plan.
- Merit Plan.
- Continuing education funds for additional certifications and certification renewal.
- Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.