Health Plan Demand Specialist

6 days ago


Los Angeles, California, United States MedPOINT Management Full time
Job Responsibilities

The Health Plan Demand Specialist at MedPOINT Management will be responsible for managing health plan audits and demands, ensuring timely and accurate responses, and maintaining meticulous records. This position involves handling communications via email and fax, data entry, and collaboration with coordinators and other team members.

Key Responsibilities:
  • Manage health plan demands, including receiving, entering, and assigning demands to coordinators.
  • Provide a preliminary Explanation of Payment (EOP) if the claim is not reprocessed and deliver the final EOP once the claim is paid.
  • Supply the original EOP to the health plan if the demand is upheld.
  • Perform health plan audits, including pulling required documents and combining them into one comprehensive file.
  • Communicate effectively with health plans and internal coordinators to ensure smooth workflow and accurate data management.

This role requires a high school diploma or equivalent, with additional education or certifications in healthcare administration or related fields being a plus. Proven experience in a clerical or administrative role, preferably within the healthcare industry, is also required. Proficiency with Smartsheet and other data entry tools is essential.

We estimate the salary for this position to be around $45,000 - $60,000 per year, depending on location and experience.



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