Relationship Coordinator

22 hours ago


Elkins Park, United States American Cybersystems Full time
Job Title: Relationship Coordinator

Innova Solutions is seeking a skilled Relationship Coordinator to join our team. As a Relationship Coordinator, you will play a critical role in providing planning and support for all lines of business and products, including Preferred Provider Organizations (PPO), Traditional, Medicare Advantage, Health Maintenance Organizations (HMO), Medicare Supplement, and Medicare Cross-over.

Key Responsibilities:
  • Provide planning and support for all lines of business and products
  • Resolve problems related to service delivery, claims processing, and procedural issues
  • Resolve common, complex, and escalated issues directly impacting Out-of-Area (HOST) provider claims
  • Track issues, provide root cause analysis, and escalate to Management
  • Partner with all areas of the company to achieve timely issue resolution and compliance with other Health Care Plans' benefits requirements
Requirements:
  • High School Diploma or GED
  • 4 years' experience in a Claims/Service operations environment or a bachelor's degree with 2 years' experience in Claims/Service environment
  • Demonstrated understanding of Products to include Medicare Advantage, Medicare Cross-over, State Health Plan, Administrative Services Only (ASO), and Fully insured and Individual products
  • National Accounts Database experience in the development, design, and execution of account-specific, customized education programs in the healthcare industry is preferred
What We Offer:
  • Competitive pay range: $28 - $30 per hour
  • Benefits package, including medical and pharmacy coverage, dental and vision insurance, 401(k), health savings account (HSA), and flexible spending account (FSA)
  • Opportunities for professional growth and development
About Innova Solutions:

Innova Solutions is a global company with a presence in North America, Asia, and Europe. We deliver strategic technology and business transformation solutions to our clients, enabling them to operate as leaders within their fields. We are committed to providing our employees with a work environment free of discrimination and harassment.



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