Document Service Representative

Job Description

Document Service Representative | Aditi Consulting

The Tone:
This is a contract role at Aditi Consulting, an organization supporting various business functions. This role is crucial for the efficient and accurate processing of all incoming organizational mail, paper claims, and correspondence documents. The Document Service Representative plays a vital part in maintaining operational flow by ensuring documents are correctly examined, data-entered, and routed to the appropriate departments.

The TL;DR
• Role: Contract / Early Career
• Type: Contract
• Location: In-person (specific location not provided)
• Pay: $18.00–$19.00/hr.
• Team: Reports to Team Lead, Document Management, collaborating with Member Services, Provider Services, Claims Operations, and Medical Affairs.
• Mission: Own the accurate and timely processing and routing of all incoming organizational mail, paper claims, and correspondence documents.
• Tech Stack: Formworks, Macess, doc flo queue.

What You’ll Actually Do
• Claim & Data Processing: Examine, data enter, and re-write all physician, hospital, dental, and pharmacy claims, performing OCR error correction, Key from Image, and Key Entry in Formworks according to established desk levels and coding guidelines.
• Document & Correspondence Handling: Facilitate and handle all incoming paper claims and correspondence documents, performing accurate data entry in Formworks, ensuring proper filing in Macess, and routing to the correct doc flo queue.
• Scanning Room Operations: Manage all scanning room functions, including sorting, prepping, scanning, and archiving incoming claim and correspondence documents, verifying completeness, and performing general scanner maintenance.
• Issue Resolution & Reporting: Identify and report scanning, data entry, workflow issues, and provider billing problems to the Team Lead or management, contributing to process improvements for claims examining and data entry.
• Compliance & Performance: Maintain production and accuracy ratios, comply with departmental turnaround times, and apply problem-solving and time management methods to balance multiple tasks while upholding quality standards.

The Must-Haves
• Background: Others. Fundamental understanding of medical claims processing, correspondence, and document management principles.
• Experience: Experience with claims examining, correspondence processing, and data entry using systems like Formworks, Macess, and doc flo queue is highly beneficial.
• Skills: Demonstrated ability to determine, analyze, and solve problems related to claims examining and data entry; ability to apply problem-solving and time management methodology; strong attention to detail and ability to meet established quality and production standards; effective verbal and written communication skills with appropriate grammar, spelling, punctuation, and sentence structure; ability to work independently with minimal supervision.
• Bonus: Providing value-added feedback regarding established desk levels and training newly hired staff when required.