Reimbursement Review Services Associate -Remote

Job Description

About Conduent

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.

You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description

Job Track Description:

  • Performs tasks based on established procedures.
  • Uses data organizing and coordination skills to perform business support or technical work.
  • Requires vocational training, certifications, licensures, or equivalent experience.

General Profile

  • Has a developed proficiency of analytical or operational processes.
  • Completes atypical assignments.
  • Works within established procedures and practices.
  • May establish the appropriate approach for new assignments.
  • Acts as a resource for colleagues.
  • Completes work with limited supervision.

Functional Knowledge

  • Has developed skills in a range of processes, procedures, and systems.

Business Expertise

  • Understanding of how best teams integrate and work together to achieve company goals.

Impact

  • Impacts a team, by example, through the quality service and information provided
  • Uses discretion to change work procedures and practices.

Leadership

  • May provide guidance and support to junior team members.

Problem Solving

  • Provides solutions to atypical problems based on existing precedents or procedures.

Interpersonal Skills

  • Exchanges information and ideas effectively.

Responsibility Statements

  • Conducts medical and pharmacy benefit insurance verifications and investigations for commercial and government payers.
  • Interprets patient insurance, prescription, and other health-related documentation.
  • Researches available alternative funding options to reduce patient’s financial responsibility.
  • Applies prescription drug benefit management techniques.
  • Examines records to transcribe medical codes.
  • Validates licensed practitioners.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

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