Administrative Coordinator

Job Summary

A ProPeer Independent Dispute Resolution (IDRE) Coordinator is an administrative position within our federal dispute resolution program. The role of the IDRE is to process the workflow of ERISA payment disputes between payor and provider. This position requires heavy attention to detail, data entry, and a high level of critical thinking. The position is electronically task driven within the workflow process and involves no external communication outside of the organization.

Essential Job Functions

• General responsibility for processing administrative components of IDRE workflow process
• Receives and coordinates dispute referrals through data entry into our portal workflow system
• Downloading and processing of clinical and administrative documentation pertaining to the dispute
• Notating disputes within the portal regarding components of the workflow process
• Verifying and processing disputes for Conflict of Interest
• Validating eligibility of the dispute within the federally based ERISA program
• Requesting fees for the dispute process from the initiating and non-initiating parties
• Processing fees received assigning to clinical dispute reviewer
• Submitting final payment determinations to all parties through auto generated emails
• Meeting daily production requirements for assigned segment of workflow
  • COI/Eligibility/Request Fees: 65 disputes daily
  • Receiving fees/downloading NOOF/assignment to clinical reviewer: 65 disputes daily
  • Submitting closure letters to all parties based on outcome: 65 disputes daily
• Conducts research driven projects surrounding cases of issue in coordination with IDRE Director
• Utilizes critical thinking to determine outlier processes in conjunction with the rules of the program
• Ensures compliance processes and procedures are adhered to for all federal requirements
• Communicates with IDRE Director regarding any disputes outside of standardized process
• Ensures seamless transition of all incoming disputes into the portal in a time sensitive manner
• Ability to work via web-based portal applications
• Ability to be resourceful and proactive in dealing with issues that may arise by working with team and IDRE Director
• Support others in a team environment

· Assumes other activities and responsibilities from time to time as directed

Knowledge and Abilities Requirements

• Ability to use Microsoft products (Word, Excel, PowerPoint, Outlook)
• Basic office equipment experience preferred (copier, fax, shipping and receiving tools)
• Written and verbal communication skills with a demonstrated ability to deliver excellent customer service
• Ability to multi-task and quickly adapt in a fast-paced environment
• Strong organizational skills
• Attention to detail
• Professional appearance
• General Typing Skills at 65wpm
• Data Entry 10 Key Skills at 5,000kph / Data Entry Alpha Numeric Skills at 10,000kph
• Proficiency in English
• Exemplary planning and time management skills
• Ability to work in high pressure, deadline driven environment
• Ability to multitask and prioritize daily workload
• High level verbal and written communications skills
• Critical Thinking Skills

· Demonstrated ability to problem solve complex, multifaceted, situations

· Ability to engage easily in abstract thought

· Strong organizational and task prioritization skills

Education and Experience:

• High School Diploma or equivalent
• 3-5 years experience in an office based professional setting

License and Certification: N/A

Driving Essential: No

Position Demands:

This position requires sitting, bending, stooping for up to 8 hours per day in an office setting. Ability to lift and move objects weighing up to 20 lbs. Ability to learn technical material. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc. Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc. The person in this position frequently communicates with guests, employees, and vendors and must be able to exchange accurate information.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All ProPeer employees and temporary team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

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