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Job Description
- Req#: 1088
Employer Industry: Healthcare Solutions
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely with occasional travel to the corporate office in Tampa, Florida
- Supportive and collaborative work environment focused on client service delivery
- Chance to make a positive impact on health care affordability and clinical outcomes
- Comprehensive benefits package including health and wellness programs
What to Expect (Job Responsibilities):
- Act as the Quality Subject Matter Expert to support service delivery
- Resolve client inquiries effectively by understanding internal processes
- Develop and execute client queries for internal reports
- Evaluate disputed claims in the denial management process for health plan reviews
- Collaborate with internal departments to recommend process improvements
What is Required (Qualifications):
- Previous experience working in a health plan or healthcare services company
- Minimum 3 years of experience in claims processing, claims coding, customer service, or account management
- Bachelor's degree preferred; 5+ years of relevant experience may substitute for a degree
- Expert proficiency in written and oral communication skills with strong attention to detail
- Working knowledge of SQL queries and advanced Microsoft Excel skills
How to Stand Out (Preferred Qualifications):
- Experience with data analysis tools
- Familiarity with reporting and JIRA
- Certification or experience in medical billing and/or medical coding
- Knowledge of laboratory medical coding rules and regulations
#HealthcareSolutions #QualityAssurance #RemoteWork #CareerGrowth #DataAnalysis
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