Job Summary:
As a Claims Coordinator, you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality patient experience within our service level agreements. The Claims Coordinator role serves as a liaison between plan members, providers and health insurance companies to get claims issues resolved. The Claims Support handles all communication, paperwork, and negotiations with a health insurance carrier or provider on the behalf of the plan member.
Responsibilities:
- Your primary objective is to provide effective and timely customer service for members, providers, insurer and clients regarding health care claims
- Ensure timely follow-up on requests for accounts to be reviewed
- Organize health insurance paperwork and medical record documentation
- Demonstrate knowledge of proprietary software and other required technology (Google apps, etc)
- Negotiate with providers on plan member balances
- Challenge denials of claims by the insurance company
- Communicate with medical offices, hospitals, laboratories, etc... in an effort to obtain relevant records for the patient’s case
- Contact providers and insurance companies to resolve claim concerns
- Assist with understanding of explanation of benefits (EOBs)
- Enabling members to get the errors fixed and recoup or lower their expenses by resolving their: medical bills, denied medical claims, medical letters of appeal
- Analyze and identify trends and patterns related to member billing complaints
- Collaborate with peers and management across functions
- Understand the evolving business requirements and adapt the operational processes to meet those requirements
- Speak clearly, confidently and have a friendly phone demeanor while demonstrating persuasion in overcoming objections
- Be able to handle a fast-paced dynamic environment with competing priorities
- Model a culture reflective of our Core Company Values; gain and maintain a thorough understanding of the Patient Care Team policies, processes, software, etc.
Qualifications:
- 1+ years claims experience required within hospital or large provider groups (10+ providers)
- 2+ years of Healthcare Collections and A/R
- Passion for providing support
- Highly effective communication, problem resolution and organizational skills
- Demonstrated ability to meet goals in a rapidly changing environment
- Excellent data and overall analytical skills
- Proven track record of driving measurable efficiency results
- Medical billing/coding certification (CPC) beneficial, but not required
- College degree preferred (additional experience in lieu of college degree will be considered)
Job Type: Full-time
Pay: $19.00 - $21.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience level:
Physical setting:
Schedule:
- 8 hour shift
- Monday to Friday
- Weekends as needed
Application Question(s):
- Do you have any experience working in a large provider group or hospital?
- Do you have a background in healthcare collections and Accounts receivables?
Work Location: Remote