Job Track Description:
Performs tasks ba
sed on established procedures.Uses data organizing and coordination skills to perform business support or technical work.Requires vocatio
nal training, certifications, licensures, or equivalent experience.
General Profile
Expands skills within an analytical or operatio
nal process.Maintains appropriate licenses, training, and certifications.Applies experience and skills to complete assigned work.Works within established procedures and practices.Works with a moderate degree of supervision.
Functional Knowledge
Has developed skillset in a range of processes, procedures, and systems.
Business Expertise
Understanding of how teams integrate and work best together to support the achievement of company goals.
Impact
Impacts a team, by example, through the quality service and information providedFollows standardized procedures and receives moderate supervision and guidance.
Leadership
Has no supervisory responsibilities.Manages own workload.
Problem Solving
Uses existing procedures to solve standard problems without supervisory approval.
Interpersonal Skills
Exchanges information and ideas effectively.
Responsibility Statements
Audits payment determination, reconsiderations, and re-reviews on Medical Bill Data.Assists in assigning procedure codes regarding complex issues and comprehensive exam codes.Examines and adjusts lower-level technical bills, including high-level office visits, reports, and record reviews.Analyzes medical reports, test results, and treatment plan to determine proper payment or reimbursement.Maintains reference library of company and industry reimbursement policiesCo
nducts test studies for the compliance team, requiring high-quality results and strict deadlines.Performs other duties as assigned.Complies with all policies and standards.
A Business Process Services PioneerAs one of the original pioneers in business process outsourcing (BPO) and a leader today, Conduent has deep and diversified expertise across a range of industries and business process solutions. We help businesses and governments drive process efficiencies, costs savings and long-term revenue growth. Our understanding of our clients’ operations enables us to provide essential services to millions of people every day. Whether it’s helping to reduce ER visits by 25%, driving 99% customer satisfaction, delivering $150B in child support payments or reducing traffic congestion by 15%, Conduent’s services and solutions positively impact the lives of millions of people every day.