Program Assistant II
About The Position
Tryfacta is seeking a Program Assistant II for our client in Madison, WI 53703. This is a temporary contract assignment. The role involves working with medical billing and records, which can be complex. Responsibilities include reviewing, analyzing, and processing medical cost disputes related to worker's compensation claims, investigating disputes regarding the reasonableness of medical fees and pharmacy fee schedules, and gathering additional information from various parties. The assistant will utilize databases to track disputes and claims, and prepare draft orders and documentation. Assistance in preparing cases for review related to medical necessity disputes is also required.
Requirements
- Strong written and verbal communication skills.
- Knowledge of customer service, dispute resolution, and investigative techniques.
- Ability to interpret statutes, rules, and medical documentation.
- Proficiency in Microsoft Office and working with databases.
- Basic math skills and attention to detail.
- Ability to work independently and in a team environment.
Nice To Haves
- Knowledge of medical terminology and healthcare coding is preferred.
Responsibilities
- Review, analyze, and process medical cost disputes related to worker's compensation claims.
- Investigate disputes regarding reasonableness of medical fees and pharmacy fee schedules.
- Gather additional information from employers, insurers, employees, attorneys, and medical providers.
- Utilize databases and systems to track disputes, claims, and case progress.
- Prepare draft orders and documentation in accordance with applicable laws and regulations.
- Assist in preparing cases for review related to medical necessity disputes.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
