IS Support Associate

Primary Purpose:

To provide general support to the IS Department, ensure accurate and timely data entry into the primary processing system, and provide Level 1 on-site and remote IT support, including support for the Aerial Care Coordination application.

Principal Duties and Responsibilities (* = essential functions):

• Responsible for manually adding and updating membership data in MedMC & EZ CAP. *
• Responsible for monitoring and work requests received via the Aerial Care Eligibility Task list for each IPA daily and Aerial Provider Registration requests at least twice weekly for each IPA *
• Manage the Eligibility email box daily, including handling all email and faxed eligibility inquiry and update requests. *
• Oversee the ECR (Electronic Claim Retrieval) process, including retrieving files, loading files to MedMC, working and researching issues, and all related tracking and reporting. *
• Assist with reviewing and working on monthly Eligibility Edit reports. *
• The specialist will review and correct rejected or mismatched claims in the EZ-Net portal to ensure accurate data formatting before final adjudication.
• Work and respond to internal and Health Plan out-of-pocket requests, updating the primary processing system accurately.
• Assist in monitoring IT tickets submitted by PDT staff to ensure efficient, complete responses. *
• Act as Level 1 Onsite and remote IT Technical support to PDT staff. *
• Manage and track all PDT IT Equipment *
• Provide individual and group user training related to IT & IS supported software and hardware *
• Accurately interpret and apply departmental policies and procedures using sound judgment.
• Assist with the troubleshooting of issues and testing of updates
• Provide cross coverage and support to other IS staff.
• Other duties as assigned.

Job Specifications (KSAs):

• Strong attention to detail and accurate, efficient data entry.
• Ability to read and understand health plan eligibility and benefit information and Division of Financial Responsibility matrices.
• Requires familiarity with medical terms, practices, and coding (CPT, HCPCS, ICD9/10, Revenue, etc.)
• Working knowledge of all Microsoft Office applications, including Excel and Access.
• High level of professionalism with good interpersonal and communication skills.
• Able to work independently on a variety of tasks and in a team setting.
• Ability to prioritize and perform a variety of complex tasks.
• Requires the ability to speak, read, write, and understand English and other general educational skills as is generally obtained by completing high school or a GED

Position Performance Criteria:

• Consistently produces quality and quantity of work related to departmental standards, accuracy measures, and goals promptly.
• Demonstrates high reliability through consistent punctuality and attendance.
• Competently performs position requirements with minimal supervision and direction, including taking initiative and assuming responsibility for follow-through.
• Uses sound judgment in time management and prioritizing work to balance multiple tasks and meet required timeframes for all activities.
• Demonstrates excellent interpersonal skills as discerned through observation and team project success.
• Accurately interprets and applies departmental policies and procedures using sound judgment.
• Communicates professionally and respectfully to peers, superiors, subordinates, and clients.
• Follows through on tasks and provides constructive feedback on assigned work projects.
• Demonstrates overall professionalism in attitude, demeanor, and personal appearance

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