Conduent Research and Correspondence Analyst in West Sacramento, California
Research and Correspondence Analyst
The Research Analyst is responsible for researching and resolving high-profile complex issues that have been referred by the Department of Health Care Services, Conduent’s internal customers, Conduent Management, as well as provider billing issues received from providers via written correspondence.
Tasks and Responsibilities
Conducts in-depth research of provider billing issues and provide resolution via written correspondence or E-mail to the Department of Health Care Services
Respond to External Customer via email on research findings
Analyzes claims billing issues and problems to identify root cause and makes recommendations for Improvement
Work with different internal and external units for claim resolution
Able to interpret Medi-Cal Policy
Prepping of claims for internal resubmissions
Monitor individual queue and response to written inquiries within the units Service Request Level Agreement
Timely follow up and tracking of claims
Participates in Xerox-required employee training
Assists with updating of Procedure Manuals, as required
Document information into CRM
Able to communicate on research findings via written response
Work independently with no supervision and make decisions related in provider research issues and high profile issues
Acts as SME’s for Systems Group and assist with solutions related to systems changes
They drive projects directed by DHCS for claim resubmissions and coordinate conference calls with provider, DHCS, and Associations
Works directly with File Maintenance on system issues and make recommendations for corrections
Assist/recommend Edit Criteria verbiage based on revised policy
Attends SDN meetings
Able to read system tables and provide support to DHCS and SG on recommended changes
Works on legislative issues that have been escalated from providers, DHCS or Xerox
Acts as Expert Witness for the claims processing system
High school Diploma or corresponding years of experience can be substituted for education
Minimum two years’ experience in claims examination and/or billing practice
Minimum one year experience with CA-MMIS billing policies and procedures
Outstanding oral and written communication skills, strong interpersonal skills, and superior
- Ability to take initiative, to maintain confidentiality, to meet deadlines, and to work in a team
Solve problems through analysis and ongoing feedback
Ability to use MS Word, MS Excel, and MS Outlook required
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 .
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 Customer Care
Primary Location United States-California-West Sacramento
Unposting Date Dec 20, 2018, 11:59:00 PM
Req ID: 18029370