Consumer Service Operations Professional

OperationsOperationsFull TimeRemoteTeam 10,001+Since 1961H1B SponsorCompany Site LinkedIn

Location

Kentucky + 4 more

Posted

16 days ago

Salary

$45.4K - $61.3K / year

3 yrs expEnglish

Job Description

• perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations • investigate and settle claims and customer service issues • research customer inquiries to resolve claims issues • provide updates to business partners and leadership • document and track issues relating to financial, system and beneficiary data • coordinate and present research findings to internal and external customers • make recommendations based on root cause analysis related to policies, procedures, claims, provider, and beneficiary data

Job Requirements

U.S. citizenship for this position
Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Service)
3 years of experience in managed care environment
3 years of claims experience processing/adjudicating professional, inpatient, and outpatient claims
Experience with TRICARE contracts and/or the military health care delivery system, or Medicare reimbursement
2 years of customer service experience
Familiarity with reimbursement terminology (ie DME, DRG, HCPCS, CPT coding, Revenue codes, etc)

Benefits

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
short-term and long-term disability
life insurance