Healthcare Claims Support Specialist

2 weeks ago

Atlanta, Georgia, United States MultiPlan Full time

Overview: Envision a workplace that promotes interpretation, innovation, and inspiration. Our team members excel by assisting healthcare payers in managing care costs, enhancing competitiveness, and fostering positive transformations. Become part of a well-established organization with a 40-year legacy dedicated to helping our clients thrive through tailored healthcare cost management solutions.

Diversity and Inclusion: Our commitment to diversity, inclusion, and belonging is woven into the fabric of our organization. We aim to cultivate a workplace that encourages mutual respect and collaboration, enabling every talented individual to contribute and perform at their best. At MultiPlan, we are where bright minds come to shine.

Position Summary: This role focuses on addressing inquiries from members, clients, and providers, particularly regarding balance bills and appeals, with a strong emphasis on educating members about the Patient Advocacy Center process.

Key Responsibilities:

  • Manage the primary phone line and respond to all inquiries.
  • Ensure timely responses to member inquiries, including educational support.
  • Document all events related to medical claims clearly.
  • Maintain a daily inventory of claims, prioritizing tasks accordingly.
  • Handle emails, incoming calls, and inquiries, directing specific questions to the appropriate parties.
  • Receive, review, and forward incoming correspondence.
  • Perform daily tasks such as sending letters to members and recording contact information.
  • Keep the Lead Patient Advocate informed of critical issues.
  • Assist in maintaining a clean and safe workplace environment.
  • Ensure compliance with HIPAA regulations and requirements.
  • Demonstrate a commitment to the Company's core values.
  • Note: This role involves exposure to sensitive data, categorizing it as a High-Risk Role.
  • The responsibilities outlined above are not exhaustive; additional duties may be assigned as necessary.

Job Scope: This position operates under direct supervision in a self-directed and results-oriented manner. The incumbent works within established standards and procedures, relying on a broad range of knowledge acquired through training and experience to fulfill assigned responsibilities. The work may often be varied and complex, requiring regular interaction with all levels of internal and external stakeholders to achieve objectives while considering the needs of both external and internal customers.

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