Job details
Salary $16.83 an hour job type full-time
Full job description
Imagine a workplace that encourages you to interpret, innovate and inspireOur employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive changeYou can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client`s needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our companyWe strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best workWe are multiplan and we are where bright people come to shine!
This position is responsible for contacting healthcare providers to discuss negotiations for a specific dollar range of eligible claims/bills prior to payment, in order to achieve maximum discounts and savings on behalf of payor/client.
Job roles and responsibilities:
1Manage a high volume of healthcare claims thoroughly to maximize savings opportunities on each claim within the established department production standards and individual goals by contacting provider on all assigned claims and presenting a proposal while maintaining high quality standards.
Perform provider research to provide support for desired savings
Address counter-offers received and present proposal for resolution while adhering to client guidelines and policy and procedures
Seek opportunities to achieve savings with previously challenging/unsuccessful providers
Seek opportunities to establish ongoing global or concurrent agreements for future claims
Update provider data base for reference and claims processing on subsequent claims
2Initiate provider telephone calls as often required with respect to proposals, overcome objections and apply effective telephone negotiation skills to reach successful resolution on negotiated claims.
Up to 40% of time will be on phone with providers
Provider education to providers online provider portal services available for proposal review and approval
3Meet and maintain established departmental performance metrics
4Handle post claim closure service inquires, including payment status and defending original negotiation terms.
5May require acd phone responsibilities and tracking outcomes.
6Collaborate, coordinate, and communicate across disciplines and departments.
7Ensure compliance with hipaa protocol.
8Demonstrate company`s core competencies and values held within.
9Please note due to the exposure of phi sensitive data - this role is considered to be a high risk role.
10The position responsibilities outlined above are in no way to be construed as all encompassingOther duties, responsibilities, and qualifications may be required and/or assigned as necessary.
Job scope:
The individual adheres to company policies and customer specific procedures to meet control standardsThe individual relies on established instructions and procedures, applies basic skills and may develop advanced skills using tools and equipment appropriate for the positionDuties and tasks are standardized and generally contain written instructions, allowing an individual to resolve routine questions and problems, and referring more complex issues to a higher levelWork is subject to defined work output standards and production which involves high volume claims resolutionWork involves direct contact with internal and external customers.
Job requirements (education, experience, and training):
Minimum high school diploma or ged along with six (6) months experience within the healthcare industry (provider billing, medical coding, provider collections, insurance or managed care); a full year of experience is high preferable.
Knowledge of applicable laws and statutes (state, local or federal) for positions focusing on workers` compensation or automobile medical (`auto`) bills a plus
Knowledge of general office operations and/or experience with standard medical insurance claim forms
Good communication (verbal, written and listening) teamwork, negotiation and organizational skills
O ability to process verbal and written instructions
O display professionalism by having a positive demeanor, proper telephone etiquette and use of proper language and tone in a business professional environment.
Ability to:
O commit to providing a level of customer service within established standards
O provide attention to detail to ensure accuracy including mathematical calculations
O identify issues and determine appropriate course of action for resolution
O organize workload to meet deadlines and participate in department/team meetings
O adjust/alter workflow to meet deadlines in a fast-paced environment
O work independently and handle confidential information
Ability to use software and hardware related to job responsibilities, including ms word and ms excel spreadsheets and database software
Required licensures, professional certifications, and/or board certifications as applicable
Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
Benefits
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programsOur work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
Medical, dental and vision coverage (low copay & deductible
Life insurance
Short- and long-term disability
401(k) + match
Generous paid time off
Paid company holidays
Tuition reimbursement
Flexible spending account
Employee assistance program
Summer hours
Eeo statement
Multiplan is an equal opportunity employer and complies with all applicable laws and regulationsQualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran statusIf you`d like more information on your eeo rights under the law, please click here.
Job type: full-time
Pay: $16.83 per hour
Work location: multiple locations
