Rochester Public Schools

About Rochester Public Schools

Determines appropriate benefit application for medical claims submitted to the Rochester Public Schools' self-insured program. Responsible for insuring accurate, consistent and timely claims adjudication per the plan of benefits and claim processing policy and procedures. Is responsible for analyzing and monitoring the progress of claims to determine the insurer’s liability. Provide customer service and claims service to members and Providers regarding the plan of benefits, claims status, and benefit eligibility. Effectively communicate with members explaining insurance procedures and benefit interpretations. Participates in employee meetings as requested, assists with preparing materials, communicating and presenting benefit and premium changes. Works collaboratively with office team providing clerical and customer service supporting all areas of Insurance Services. Works independently on assigned claims within the claims processing team. Accepts and performs other duties within the level of responsibility of position as assigned by the Supervisor and Coordinator. Qualifications Displays excellent written and verbal communication skills and have professional interpersonal skills. Proficient Office technology skills including Microsoft Word, Excel, and ability to use data base software specific to claims processing. Ability to learn and work on multiple computer programs. Ability to work effectively in an office setting handling sensitive and confidential information. Ability to prioritize, organize, problem solve, manage multiple tasks, take initiative, presents a willingness to be an active and positive member of the office staff in support of District staff. Critical attention to detail. Health Insurance Claims processing experience preferred. Knowledge of medical and/or insurance terminology and coding, and/or patient accounts experience helpful. Ability to interpret and communicate plan provisions and policies. Must be dependable and adaptable to work independently and in a team environment. Must be able to work with frequent interruptions. Minimum of a high school diploma or GED required. Required Dispositions: In addition, the specific skills/educational qualifications for this include: Believes that all students can attain high levels of learning. Takes responsibility for the learning of our students and his/her own performance. Possesses the knowledge and skills to build effective educational experiences that benefit all students. Functions as an effective member of the educational/school team. Won't shy away from today's educational challenges. Utilizes effective interpersonal skills. Has a proven track record of success. Works with great integrity Common and Shared Accountabilities for All Positions Employees of the Rochester Public School District #535 are expected to support the goals, model and promote an environment that is respectful for all, and work collaboratively with other staff to focus on the needs of the learner. A quality, customer focus that conveys a welcome attitude, an adaptability to change, and a desire for continuous improvement is also expected of all employees. In addition, staff are to respect confidential matters, encourage a safe and secure environment throughout the schools, and be dependable and accountable employees. District Information: Please visit www.rochesterschools.org to learn more about Rochester Public Schools. Attachment(s): 2019-2020 - 260 DAY CALENDAR.pdf 0 Email To A Friend Print Version

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