Claims Liaison Specialist

4 days ago


Philadelphia, Pennsylvania, United States Top Stack Full time
About Our Company

At Top Stack, we believe that technology should enhance humanity, not replace it. We're dedicated to delivering exceptional results and building strong relationships with our clients.

Our company culture values transparency, consistency, and timeliness. We strive to create a positive work environment where our employees feel valued and empowered to succeed.

We're looking for talented individuals who share our vision and are passionate about making a difference in the human capital industry.

Job Responsibilities:

  • Serve as a liaison between healthcare plans, resolving claims-related issues and ensuring compliance with healthcare products and standards.
  • Analyze trends related to claims processing and service delivery, providing root cause analysis for escalated issues.
  • Develop and deliver educational materials for providers regarding claims policies and processing.
  • Manage inquiries and issues from partner plans, ensuring timely resolution.
  • Work closely with various departments to ensure compliance with healthcare products and standards.
  • Utilize internal reporting tools to analyze data and meet healthcare plan requirements.
  • Lead initiatives to identify and implement system updates or changes to improve operational efficiency.

Requirements:

  • A High School Diploma or GED with 4 years of experience in a claims/service operations environment; or a Bachelor's degree with 2 years of experience in a claims/service operations environment.
  • A strong understanding of inter-plan policies, processing standards, and Host/Home responsibilities.
  • Familiarity with Inter-Plan Systems and healthcare products.
  • Experience in developing and executing customized education programs in the healthcare industry is preferred.

Salary: $70,000 - $90,000 per year, based on experience and qualifications. We offer a comprehensive benefits package, including health insurance, retirement savings, and paid time off.



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