OSS Coordinator

PRIMARY PURPOSE

To support and maintain the claims management system for a local office or multiple office locations; and to ensure security access meets established policies within assigned group.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Completes examiner update reports, claim adjustments, provider requests and operational expense check requests.
• Queues claims for Managed Care; transfers payment allocations; and runs manual pre-pay and balances as requested.
• Creates and maintains internal and external logins and the applicable security access for the company's claims management systems by determining the validity for incoming requests and whether they meet established policies.
• Collaborates with company's internal audit group to ensure security access is defined and implemented according to established policies and procedures.
• Coordinates with other internal departments to support the security needs of end-users.
• Researches and gathers data as needed for auditing, special projects or returned checks.
• Provides telephone support to end-users.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Supports the organization's quality program(s).

Qualifications

• High School diploma or GED required. Associate degree preferred.
• Two (2) years of claims management or insurance experience or equivalent combination of education and experience required.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

WORK ENVIRONMENT

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding, travel as required.
• Auditory/Visual: Hearing, vision and talking.