Offer summary

Qualifications:

High School Diploma / GED or equivalent work experience., 1+ year of healthcare billing and/or health plan experience., Basic understanding of PPO benefits and medical terminology., Experience with Google workspace tools like Gmail, Sheets, and Docs..

Key responsibilities:

Coordinate between departments to resolve member billing issues.

Research claims issues and respond to member billing inquiries.

Maintain accurate documentation in the claims system for all transactions.

Report problems and denial trends to management, ensuring compliance with privacy regulations.

Job description

Primary Responsibilities

Coordinate between departments to resolve member billing issues, including, but not limited to contacting providers and/or facilities to update insurance information and resolve billing discrepancies.
Research claims issues resulting in member balance billing
Responds to member billing inquiries through written correspondences and/or phone calls.
Handles sensitive member interactions.
Maintains timely, accurate documentation in the claims system for all appropriate transactions.
Reports problems, errors, and denial trends to management including PHI breaches.
Meets the performance goals established for the position in the areas of: efficiency, accuracy, quality, member and provider satisfaction.

Required Qualifications

High School Diploma / GED OR equivalent years of working experience
Must be 18 years of age OR older
1+ year of healthcare billing and/or health plan experience.
A basic understanding PPO benefits

Preferred Qualifications

Healthcare / Insurance billing industry experience
Medical terminology acumen and experience
Billing experience and understands multiple billing requirements across various payers and states. Knowledge of billing in the state of Texas is a plus.
Experience working in the Google workspace (Gmail, sheets, docs).

Telecommuting Requirements

Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
Must live in a location that can receive an approved high-speed internet connection or leverage an existing high-speed internet service.

Soft Skills

Ability to multi – task and to understand multiple products and multiple levels of benefits within each product
Previous work experience in a fast – paced environment requiring multi – tasking skills
Ability to resolve calls, avoiding escalated complaints
Ability to exhibit empathy and be courteous to callers
Ability to triage and handle escalated situations
Ability to work in a fast – paced environment
Ability to adapt to changes
Ability to work independently and as part of a team

Required profile