Xerox Reimbursement Specialist in United States
Xerox is the world's leading enterprise for business process and document management. Its services, technology, and expertise enable workplaces - from small businesses to large global enterprises - to simplify the way work gets done so they operate more effectively and focus more on what matters most: their real business. Xerox offers business process outsourcing and IT outsourcing services, including data processing, healthcare solutions, HR benefits management, finance support, transportation solutions, and customer relationship management services for commercial and government organizations worldwide. The company also provides extensive leading-edge document technology, services, software and genuine Xerox supplies for graphic communication and office printing environments of any size. Xerox serves clients in more than 160 countries. For more information, visit www.xerox.com, www.news.xerox.com, www.realbusiness.com or www.xerox.com/businessservices.
If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.
Primary Duties and Responsibilities
May perform one or more of the following duties:
Supports the Utilization Review process, including certification of services/procedures based upon national benchmarks (Assistant Level)
Performs certification of services/procedures (concurrent and retrospectively) – Associate Level
Acts as patient/family advocate in coordinating and accessing medical necessity health care services within the benefit plan (Associate Level)
Performs Condition Management services which includes educating members on self-management of a chronic condition in order to facilitate the best health possible (Associate Level)
Manage cases to conclusion, and ensure that the goals identified in the condition management plan are met (Associate Level)
Establishes and maintains effective working relationships with patients and their families, providers and payers.
Refers patients to appropriate resources to allow for positive outcomes relating to their chronic illness.
Facilitates electronically filing of medical records in the appropriate format and location
Responds to phone calls from providers regarding existing cases
Educate and assist patients in understanding and self-manage their chronic conditions within current medical practice
Participates in quality improvement strategies by assessing individual and employer satisfaction of programs.
Identifies and addresses quality issues.
Identifies potential cost savings within a health plan's coverage.
Acts upon cost savings in instances when services would not be sacrificed by doing so
Obtains/maintains knowledge of Federal, State and Local funding and community resources available to patients and their families
Researches and assists in development of new company programs or policies.Assist in evaluation and refinement of existing policies.
Make recommendations to achieve maximum efficiency.
Licensed Practical Nurse.Skill
Has substantial understanding of the job and applies knowledge and skills to complete a wide range of tasks.Job Complexity
Works on assignments that are moderately difficult, requiring judgment in resolving issues or in making recommendations.
Normally receives little instruction on daily work, general instructions on newly introduced assignments.Experience
Typically requires a minimum of 2 - 4 years of related experience.
NOTE: Nonexempt jobs often require a high school diploma or its equivalent and/or vocational training.*The information above has been designed to indicate the general nature and level of work performed by employees in these jobs.
It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to these jobs.
Xerox is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, sex, marital status, sexual orientation, physical or mental disability, 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 or compete for employment with Xerox may request such accommodation(s) by sending an e-mail to firstname.lastname@example.org. Be sure to include your name, the job you are interested in, and the accommodation you are seeking.
Job: Service Delivery Healthcare
Title: Reimbursement Specialist
Location: United States
Requisition ID: 16025757
Other Locations: United States-New Jersey-Somerset
Virtual/work from home? No