Business Claims Associate

2 days ago

Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time
About Avalon Healthcare Solutions

Avalon Healthcare Solutions is a leading provider of healthcare services, dedicated to delivering high-quality care to patients across the country. Our team of experienced professionals is committed to excellence in every aspect of our work, from claims processing to patient care.

Job Summary

We are seeking a highly skilled Business Claims Associate to join our Claims Operations Department. As a Business Claims Associate, you will be responsible for submitting weekly Provider Reconsideration faxes to multiple health plans, providing follow-ups when necessary, and uploading faxed confirmations and health plan determination letters to in-process tickets. You will also be expected to monitor the Reconsideration queue to identify discrepancies, perform outbound calls and email communications to clients for status updates on ticket submissions, and facilitate issue resolution.

Key Responsibilities
  • Submit Provider Reconsideration tickets to multiple health plans
  • Evaluate disputed claims in the Reconsideration process and share findings with senior staff to determine scope
  • Upload health plan determination letters to appropriate Reconsideration tickets
  • Track provider issues and monitor trends to support their resolution
  • Update and respond to provider ticket requests within established turnaround times
  • Provide excellent customer service to providers
  • Collaborate with other departments to support provider needs
  • Perform outbound calls to health plans to investigate aging reconsideration submissions and claims payment details
  • Maintenance of various logs
Requirements
  • Associate's degree preferred, but not required
  • Experience working in the healthcare industry is preferred, but not required
  • Experience with provider credentialing is preferred, but not required
  • Good customer service and communication skills
  • Attentive to details and organized
  • Intermediate knowledge of Microsoft Office Suite products
  • Excellent interpersonal skills
  • Willingness to learn new skills
  • Experience with using eFax and performing outbound phone calls to clients

  • Business Claims Associate

    3 days ago

    Tampa, Florida, United States Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions, dedicated to improving clinical outcomes and healthcare affordability for millions of lives across the country.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations Department. As a...

  • Business Claims Associate

    2 weeks ago

    Tampa, Florida, United States Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a pioneering company in the healthcare industry, revolutionizing the way healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. With a proven Lab Benefit Management solution, lab science expertise, digitized lab values, and proprietary analytics,...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Administrative Services, LLC dba Avalon Healthcare SolutionsAvalon Administrative Services, LLC dba Avalon Healthcare Solutions is a leading provider of innovative healthcare solutions, dedicated to improving clinical outcomes and healthcare affordability for millions of lives. Our cutting-edge Lab Insights Platform captures, digitizes, and...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    2 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    1 week ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our mission is to improve clinical outcomes and healthcare affordability for the people we serve.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations Department. The successful...

  • Business Claims Associate

    3 days ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of healthcare services, dedicated to delivering high-quality care to patients across the country. Our team of experts is committed to ensuring that patients receive the best possible care, while also reducing costs and improving clinical outcomes.Job SummaryWe are seeking a...

  • Business Claims Associate

    2 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    2 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    1 week ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions. Our company is headquartered in Tampa, Florida, and we are committed to delivering high-quality services to our clients.Job SummaryWe are seeking a highly skilled Business Claims Associate to join our Claims Operations...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Administrative Services, LLC dba Avalon Healthcare SolutionsAvalon Administrative Services, LLC dba Avalon Healthcare Solutions is a leading provider of innovative healthcare solutions, dedicated to improving clinical outcomes and healthcare affordability for millions of lives. Our cutting-edge Lab Insights Platform captures, digitizes, and...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Administrative Services, LLC dba Avalon Healthcare SolutionsAvalon Administrative Services, LLC dba Avalon Healthcare Solutions is a leading provider of innovative healthcare solutions, dedicated to improving clinical outcomes and healthcare affordability for millions of lives across the country.Job SummaryWe are seeking a highly skilled...

  • Business Claims Associate

    3 weeks ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Administrative Services, LLC dba Avalon Healthcare SolutionsAvalon Administrative Services, LLC dba Avalon Healthcare Solutions is a leading provider of innovative healthcare solutions, dedicated to improving clinical outcomes and healthcare affordability for millions of lives. As a pioneering Lab Insights company, we bring together our...

  • Business Claims Associate

    1 week ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of lab insights and benefit management solutions, dedicated to improving clinical outcomes and reducing costs for healthcare insurers.With a proven track record of delivering 7-12% outpatient lab benefit savings, Avalon has established itself as a trusted partner for health...

  • Senior Claims Associate

    6 days ago

    Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time

    About Avalon Healthcare SolutionsAvalon Healthcare Solutions is a leading provider of Lab Insights solutions, revolutionizing the way healthcare insurers approach care and reduce costs. Our innovative platform captures, digitizes, and analyzes lab results in real-time, empowering informed decision-making and driving better clinical outcomes.Job SummaryWe are...

  • Claims Account Executive

    3 weeks ago

    Tampa, Florida, United States Truist Full time

    Job SummaryWe are seeking a highly skilled Claims Account Executive to join our team at Truist. As a Claims Account Executive, you will be responsible for managing and delivering complex claim and coverage evaluations on all insurance lines, providing value-added claim consulting services to clients, and driving business growth through strategic client...

  • Claims Management Associate

    4 weeks ago

    Tampa, Florida, United States KING'S INSURANCE STAFFING LLC Full time

    Job Summary:KING'S INSURANCE STAFFING LLC is seeking a highly motivated and detail-oriented Auto Liability Claims Associate to join their team in Florida. This entry-level position is ideal for individuals looking to start a career in insurance claims management, focusing on assessing and processing liability claims.Key Responsibilities:Assess and process...

  • Claims Manager

    1 week ago

    Tampa, Florida, United States Truist Full time

    Job SummaryWe are seeking a highly skilled Claims Manager to join our team at Truist Financial Corporation. As a Claims Manager, you will be responsible for leading a team of experienced claim professionals and managing the workflow of claims teams.Key ResponsibilitiesCoach and develop claim team members to identify client needs and develop strategies for...

  • Business Development Associate

    3 weeks ago

    Tampa, Florida, United States CW Business Development Full time

    Job DescriptionWe are seeking a highly motivated and versatile Entry-Level Business Marketing Associate to join our team at CW Business Development. As a Business Marketing Associate, you will play a crucial role in providing exceptional customer service and sales support across various communication platforms.Key Responsibilities:Act as the primary point of...