Performs routine and complex audits on phone calls and claims adjudication.
Researches claim processing problems and errors to determine their origin and appropriate resolution.
Provides prompt customer service to members, providers, billing departments, and other insurance companies regarding claims.
University of Utah Health is an integrated academic healthcare system with five hospitals, community health centers, and a health plan. It is nationally ranked and recognized for academic research, quality standards and overall patient experience with over 1,600 providers.
Perform in-depth quality audits on customer support calls and email cases.
Ensure accuracy of information and professionalism in customer interactions.
Propose documentation updates to enhance the Customer Service Representative (CSR) experience.
Evry Health aims to bring humanity to health insurance with high-technology health plans that expand benefits, increase access and transparency, and feature a personalized, human approach. They are the major medical division of Globe Life (NYSE:GL), which has 16.8 million policies in force, more than 3,000 corporate employees and 15,000 agents.
Audits client data and generates high quality recoverable claims for the benefit of Cotiviti and our clients.
Conduct advanced, strategic analysis of paid claims, uncovering critical audit insights that drive process improvements and enhance organizational knowledge.
Make determinations based on prior knowledge and experience of client contract terms with the likelihood of recovery acceptance.
Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. They are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth.
Handle customer inquiries and analyze payment history.
Communicate account statuses and recommend solutions.
Maintain accurate records of customer interactions.
Sutherland is a digital transformation company that helps customers globally achieve greater agility and transform automated customer experiences. As a Great Place to Work certified company, they have been in business for over 35 years and work with well-known brands.
Research and interpret payer policies in accordance with healthcare coding and regulatory requirements.
Identify common error areas that can be made into automated software logics that prevent overpayments.
Develop claims editing logics that promote payment accuracy and transparency across lines of business.
Rialtic is an enterprise software platform empowering health insurers and healthcare providers to run their most critical business functions. Founded in 2020 and backed by leading investors, they are tackling a $1 trillion problem to reduce costs, increase efficiency and improve quality of care.
Manage a caseload of in-progress applications through the underwriting process
Coordinate and follow up on medical exam bookings with vendors and clients
Handle inbound calls and respond to client emails
PolicyMe is Canada’s leading digital insurance solution, offering straightforward and affordable financial protection for families. They operate with a remote-first culture, attracting top talent from across Canada, with employees who are ambitious, yet humble.
Demonstrate experience interpreting and responding to customer requests through, understanding the customer's needs, and identifying actions to help achieve customer objectives quickly
Help consumers understand credit bureau processes and educate them in appropriate steps to request corrections
Provide information about credit-related memberships, services, and product offerings; advocate for solutions that will help callers improve their creditworthiness
Experian is a global data and technology company, powering opportunities for people and businesses around the world. As a FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 22,500 people across 32 countries.
Responds to telephone inquiries promptly, professionally, and efficiently to provide resolution.
Analyzes provider questions to determine best use of resources to resolve the situation.
Empower AI provides federal agency leaders with tools to elevate their workforce's potential for transformation. They leverage three decades of experience solving complex challenges in Health, Defense, and Civilian missions and are headquartered in Reston, VA.
Completes and submits all required documentation in an accurate and timely manner.
Develops and maintains accurate files on each key referral source to provide the location with client information needed to build strong client and branch ties and deliver customer satisfaction.
CommonSpirit Health is a full-service health care organization that believes the best place for our patients to heal is in their own home. As a faith-based organization, they are committed to finding new ways to improve the health of patients and the health of the communities they serve.
Manage multiple channel interactions professionally and efficiently.
Effectively present products/services to providers with integrity, understanding, and accuracy.
Focus on provider retention through first call resolution and maintain positive relationships.
Capital Blue Cross promises to go the extra mile for its team and community. Employees consistently vote it one of the “Best Places to Work in PA”, valuing professional/personal growth by investing heavily in training and continuing education.
Answering questions related to HealthCheck360 products, services, and programs through phone, email and chat
Assisting with tasks such as processing Physician’s Screening Forms and participant outreaches
Providing feedback and solutions to improve efficiencies and the participant experience
Cottingham and Butler’s Health and Wellness division focuses on reducing medical costs while increasing employee engagement and productivity. They provide onsite biometric screenings, technology and programming, risk-specific targeted communications, and behavior change programs.