NASCO Benefits Coders-Work At Home

[tam2005]

Location: Atlanta, Virtual Office
Description: If you are an experienced NASCO Benefits Coder who would like the opportunity to work from your home office we need to talk today!
Our client is a national provider of services to one of the nation's largest healthcare providers.

If you have NPS (NASCO Processing System) Benefits Coding experience and are looking for an exciting opportunity for a telecommuting position, we need to talk. This telecommuting contract position is forecasted for a 12 month contract.

Job Title:
Benefit Coder

Job Summary:
Under General supervision, the Benefits Coder role is accountable for performing quality testing on benefit coding completed within the NPS benefit file, as well as to perform extensive NPS benefit file coding and support duties. This position will review NAEGs, Certs and Riders, and other benefit related documentation in order to build benefit coding requirements and test matrices, run test claims using tools such as NPS Electronic Error Correction (EEC) and Compuware tools, clarify requirements with internal and external sources, document and report quality results, make simple coding changes to the benefit file, and ensure that a high quality benefit code is moved into the system. Communicates with NASCO customers and Team leads on status of assignments in the performance of day to day testing.
Essential Roles and Responsibilities:
• Reads customer documentation, such as a "NAEG", to clarify business coding requirements for benefit coding. 10%
• Builds coding grids for the benefit coder. 15%
• Builds unit test plans and schedules 15%
• Enters data into NPS table and GENO tables utilizing input from customer submitted CSR's. 10%
• Enters coding into the NPS Benefit File utilizing input from customer submitted CSR's or Benefit Analyst submitted instructions.10%
• Performs product validation activities including test planning, test development, issue/defect triage and test execution by performing a variety of tests on the NPS code to ensure claims process according to specifications or to determine cause of claim failure using EEC or Compuware tools 10%
• Communicates with Plan customers and team leaders to validate testing desired outcomes 5%
• Analyzes quality problems as related to customer assigned problem logs.15%
• Builds and Runs Test Claims from subscriber information on NPS, working those claims to ensure that they process through the system, and obtaining the results from the claim processes. 5%
• Builds Test membership in membership system in order to run test claims 5%
Nominal time spent
• Documents and distributes results to team lead and coder through email.
• Verifies needs and impacts of test issues on users' and NASCO's system environments
• Performs various reporting on quality analysis and trends
• Compares results with specifications and records test data
• Analyzes test results to determine cause of failure, applying knowledge of claims process and benefit terminology
Additional Roles and Responsibilities:
A. Performs other duties as assigned by manager or team lead


Required Job Competencies:

Knowledge:
• Knowledge of Healthcare Insurance terminology. Has worked in the healthcare field so that they are aware of benefit terminology as found in the certificates and riders of health insurance documents.
• Knowledge of health insurance claim forms. Claim forms and claim form field knowledge so that claims can be manipulated by working the appropriate field in order to adapt claims to different scenarios.
• Benefit Coding in healthcare environment.
Skills:
• Strong attention to detail
• Test plans
• Outstanding written and oral communication skills
• Outstanding organizational skills

Success Factors:
• Ability to work in the NPS in order to input and work claims for payments
• Ability to review claim output and compare to expected results.
• Ability to translate benefit coverage into a claim scenario test matrix
• Self motivated and a self starter
Experience:
• At least 1 year adding and processing health care claims or equivalent experience
• At least 1 year processing health care claims
Desired Job Competencies:

Knowledge:
• GEM system knowledge
• Knowledge of software quality assurance testing
• Knowledge of testing processes and procedures. Experience with quality and testing process and procedures
Skills:
• High level of written and verbal communications
Success Factors:
• Patience in learning a very unique and difficult programming process under a two year training and apprenticeship.
• Ability to write test strategies, test plans, test cases and test scripts to assess application conformance
Experience:
• Systems coding.
• At least 1 year adding and processing claims into the NASCO claim system
• At least 1 year processing claims on the NPS


Required Training and Education:

A. Education on benefit language and knowledge in the Health Insurance field.
Desired Training and Education:

A. Programming in any computer language.
B. Training on NPS claim processing
C. Training in medical billing.

Working Conditions:
• Working in an indoor environment with central heat/air.
• Must be able to sit and use equipment at workstation for up to 7.5 hours daily.
• Must be able to travel in order to meet with clients at their location at the appointed time.