Southern Premier Administrators (SPA), a subsidiary of USA Managed Care Organization (USAMCO), is a dynamic third-party administrator in the Life and Health insurance industry. SPA administers both group and individual insurance products on behalf of insurance carriers, associations, and self-insured plans.
SPA is currently seeking a full-time Medical Claims Repricer I to join its growing Claims team! This is a paperless processing role with little to no inbound/outbound calls per day. The Repricer role reports to the Claims Manager in our Austin, TX office. This is an exciting opportunity to join an expanding company with career-growth opportunities.
Roles and Responsibilities:
- Adhere to HIPAA, Confidentiality, and Security requirements
- Reprice Medical Claims using HCFA and UB forms, as well as system information, focusing on procedural, contractual, and overall accuracy throughout the process
- Achieve clearly defined production and quality metrics as defined by role, length of service, etc.
- Occasional overtime due to volume and turnaround-time requirements
- All other job duties as assigned
Qualifications:
- Education: High School diploma/GED
- Minimum 2 years of recent claims-processing experience with ICD/CPT coding
- Experience with Group PPO plans in a multi-tenant environment, a plus
- General computer knowledge, with ability to learn multiple systems and independently transition between home and office locations when needed
- Experience with AS400/iSeries, a plus
Skills:
- Meticulous attention to detail
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- Ability to communicate effectively and respectfully
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- Strong work ethic and drive
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- Professional demeanor and coachable attitude
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SPA Claims Department:
- Currently 37.5-hour work week: Monday through Friday, 8:00 – 4:30 CT with 1 hour lunch
- Dress code: Business Casual
- Company laptop provided for convenience
*Non-qualified or over-qualified applicants may be contacted for other roles within the USAMCO organization.
