Administrative Assistant III-Claims (Full-time, Morrisville, North Carolina Based)

Alliance Health•Durham, NC

1d•Hybrid

About The Position

The Administrative Assistant III provides administrative support to the claims team to ensure the efficient operation of the team, including handling high volume incoming and outgoing mail and high-volume inbound calls. The Administrative Assistant III also completes specific claims-related responsibilities including performing a range of clerical tasks, maintaining databases and spreadsheets, conducting research, preparing reports, handling inquiries, receiving/screening/keying paper claims, and other activities that require knowledge of program operations, policies, and processes.

Requirements

High School diploma or equivalent and four (4) years of experience involving substantial public contact, information gathering, and written communication; OR Completion of a two-year business administration program and two (2) years of related experience; OR Bachelor’s degree in business administration, public administration, or other related fields.
Knowledge of office management techniques.
Knowledge of Microsoft Office products.
Skill in communicating, both verbally and in writing.
Skill in organizing workflow and coordinating activities.
Skill in developing presentations, presentation materials, and reports.
Ability to use audiovisual equipment and to train others in its use.
Ability to establish and maintain effective working relationships with subordinates, peers, management, and the general public.
Ability to coordinate a variety of resources in gathering information and independently answering inquiries.
Ability to exercise independent judgement and discretion.
Ability to plan and supervise the work of others, if applicable.
Ability to analyze and interpret policy and procedural guidelines.
Ability to resolve problems and questions independently.

Responsibilities

Maintain files, reports and other data, including aggregating data from multiple sources and uploading documents to various systems within Alliance
Manage organizational and departmental records and report on activities involving implementation of program objectives using existing procedures or devising new methods as necessary
Assign correspondence to appropriate individuals for preparation of replies
Review completed assignments for conformity with instructions, attachment of pertinent reference materials and general completeness
Writes, edits, or coordinates the preparation of correspondence or other printed material according to well established standards or readily available sources
Maintain records in Alliance Claims System (ACS) and Salesforce systems as assigned
Develop and/or revise work procedures and methods including necessary form design
Collect data and research various systems to cross check and verify information
Develop/Maintain departmental spreadsheets and databases
Assist with preparation of departmental dashboard representing department/team performance
Assist with tracking reports for departmental supervision activities
Data-entry and other projects as assigned
Receive and document paper claims received from providers
Maintain record of providers with active approved Paper Claims Submission Request forms
Screen received paper claims to determine if documents should be keyed into Alliance Claims System (ACS) or mailed back
Key appropriate claims with accuracy and following legal document guidelines
Mail back with appropriate correspondence when claims should not be keyed
Outreach to providers regarding EDI availability and configuration
Document in SharePoint all data regarding claims received, keyed, mailed back