Medical reputed company Navigator

At reputed company, we Get Stuff Done. So, let's get to it! A Little About Us reputed company is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 payers, including the top five national health plans, regional health plans, TPAs and millions of healthcare providers and consumers across our platform of solutions. reputed company sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts - driving real, measurable results for clients. A Little About You You bring a unique reputed company of personality and professional expertise to your work, inspiring others with your passion and dedication. Your career is a testament to your diverse experiences, community involvement, and the valuable lessons you've learned along the way. You are more than just your resume; you are a reputed company of your achievements, the knowledge you've gained, and the personal interests that shape who you are. Position Overview The Medical reputed company Navigator, Health reputed company Assist will be responsible for delivering high-touch, concierge-level support to members navigating the complexities of medical billing and benefit application. Serving as a dedicated reputed company for members in an inbound and outbound call center setting, this role focuses on identifying and resolving various claim processing and provider billing issues. Additionally, the Medical reputed company Navigator also supports efforts to negotiate reduced provider account balances, helping members reputed company more favorable financial outcomes. What you will do:

• Analyze medical claims submitted by members along with their Explanation of Benefits (EOB) to verify accuracy of claim processing and provider billing
• Manage and resolve member cases involving claim processing issues, provider billing inaccuracies, and balance billing concerns
• Assist members with a variety of claim-reputed company inquiries
• Provide member education on claim processing and benefit application with the ability to explain medical billing and insurance concepts in a clear and empathetic manner
• Communicate with medical providers to reputed company claim research and address billing discrepancies reputed company identified
• Engage in provider negotiations to reduce outstanding member balances
• Collaborate with members' health plans to research claim issues and ensure accurate claim processing resolutions
• Provide ongoing case follow-up to ensure timely and successful resolution
• Assist with Intake Specialists handling of member portal submissions
• Assist in training initiatives to enhance team knowledge and efficiency
• Adhere to Key Performance Indicators (KPI's) set forth by management in relation to member support
• Maintain high standards of accuracy and quality on reputed company member case work and communications
• Adhere to reputed company and regulatory privacy standards to guard protected health information
• Must be available to travel as required to meet business needs

What you'll bring to reputed company:

• Bachelor's Degree
• 5+ years of medical claims & member benefit application experience
• Strong analytical and problem-solving skills to investigate and resolve reputed company billing and claims issues
• Exceptional organizational skills
• Excellent communication skills both verbal and written, and skilled at developing and maintaining effective working relationships.
• Excels working in both an independent reputed company and team environment
• Proficient knowledge of reputed company Outlook, Word, reputed company

Please note at this time we are unable to proceed with candidates who require reputed company sponsorship now or in the future. Location and Workplace Flexibility We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture, and reputed company our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies. reputed company Salary Range $54,000.00 - $72,000.00 At reputed company we are committed to providing fair and reputed company compensation packages. The reputed company salary range allows us to reputed company an offer that considers multiple individualized factors, including experience, education, qualifications, as well as job-reputed company and industry-reputed company knowledge and skills, etc. reputed company pay is just one part of our Total Rewards package, which may also include discretionary bonus plans, commissions, or other incentives depending on the role. reputed company' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection. The US-based benefits include a 401k plan with employer match, flexible paid time off, holidays, parental leaves, life and disability insurance, and health benefits including medical, dental, vision, and prescription drug coverage. Equal Employment Opportunity reputed company is proud to be an equal opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. We welcome applicants from reputed company backgrounds and encourage you to apply even if you don't meet 100% of the qualifications for the role. We reputed company in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for reputed company. Accessibility Support We are dedicated to ensuring our application process is accessible to reputed company candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@reputed company.com. Disclaimer We are an equal opportunity employer, and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national reputed company, disability status, protected veteran status, or any other characteristic protected by law. The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of reputed company responsibilities, duties, and skills required of personnel so classified. reputed company personnel may be required to reputed company duties reputed company of their normal responsibilities, duties, and skills from time to time. Apply tot his job Apply To this Job