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SalaryOverview:
#IDCC
This position receives/responds to provider inquiries on claim issues. Researches information by reviewing plan, eligibility, and authorizations to determine appropriate resolution. Works with CSC or RCM to identify areas of opportunity and recommend solutions. Completes special assignments and analyzes provider requests. Assists other departments and interacts directly with providers.
Responsibilities: In this role, you will:
- Handles various inbound or outbound provider calls which include researching, resolving, and documenting issues.
- Handles RCM authorization and intake changes required for claims and billing processing within a 48 hour turn-around time frame.
- Analyzes data and determines if CareCentrix claims processing guidelines have been followed correctly by researching plan, eligibility, and patient authorization information.
- Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
- Participates in and contributes to performance improvement activities.
- Participates in special projects and performances other duties as assigned.
You should reach out if you have:
- High School Diploma or the equivalent required
- Must have minimum 1 year work experience.
- Two years of customer service, claims processing, medical terminology, medical services or equivalent experience required.
- Knowledge of basic spreadsheet / word processing / data entry and basic math skills required.
- Knowledge of Claims Management and URAC standards preferred.
What we offer:
- Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
- Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
- Advancement Opportunities, professional skills training, and tuition /exam reimbursement
- PayActiv - access earned income in between pay checks
- Walgreens Discount - receive up to 25% off eligible items
- Great culture with a sense of community
CareCentrix maintains a drug-free workplace
#IDCC
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.
