Relaying participant eligibility information to insurance carriers via email, fax or mail following standard operating practices.
Performing day-to-day data entry tasks and other clerical support tasks to facilitate the capture, transfer and maintenance of accurate and timely data/records.
Answering questions or explaining information to clients and participants, reviewing files, records and other documents to obtain information for a response to requests regarding a benefit plan or personal participant account status/activity.
Data EntryCustomer ServiceCommunicationOrganizationProblem Solving
Greet patients in a friendly, outgoing manner and ensure 360 communication.
Verify and explain insurance benefits and collect co-pays accurately.
Assist in clinic performance and maintain supplies.
Team Rehab is a therapist-owned network of outpatient clinics across Michigan, Illinois, Indiana, Wisconsin, and Georgia. Since our first clinic opened in 2001, we’ve built a reputation for excellent outcomes, exceptional patient satisfaction, and a workplace where therapists love to work.
Administer the day-to-day operations of benefit programs in accordance with plan documents and regulations.
Manage leaves of absence in coordination with external vendors and the payroll team.
Provide guidance and support to People & Culture Partners and employees on benefits-related matters.
Bounteous is an end-to-end digital transformation consultancy dedicated to partnering with ambitious brands to create digital solutions. They have over 4,000 expert team members across the Americas, APAC, and EMEA and an engagement model designed to align interests and accelerate value creation.
Support clinical staff by gathering data to complete the medical necessity review process.
Create and send letters to providers and/or members to communicate information.
Collaborate with care management teams and stakeholders to provide optimal service.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, and they’ve built their reputation on over 80 years’ worth of trust. They are motivated by the well-being of their members, putting them first and committing to sustainability and innovation.
Auditing incoming applications to ensure all required information is documented.
Handling multiple applications simultaneously with using BPM, Cactus, CAQH, and Facets.
Communicating effectively with providers and internal teams to resolve any issues and ensure smooth operations.
BlueCross BlueShield of Tennessee has been helping Tennesseans find their own unique paths to good health since 1945. At BCBST, they empower their employees to thrive both independently and collaboratively, creating a collective impact on the lives of their members.
Provide expert assistance to employees via phone and email.
Manage Benefits inquiries from start to finish.
Utilize cloud-based software systems and adhere to customer satisfaction criteria.
Melita is an HR, Benefits, and Payroll Outsourcing company, serving and building lasting relationships with small and mid-sized employers in the U.S. and abroad. We were founded over 30 years ago on a simple principle: To help our clients succeed, by innovating, serving, and supporting their Human Resources, Employee Benefits, and Payroll needs.
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 and have sold over $10 billion in insurance coverage since 2018.
Own and manage the member-facing phone line, delivering compassionate, timely, and solutions-oriented support.
Manage expedient and accurate Verifications of Benefits (VOBs) to ensure members can access care without delay.
Collaborate and strategize cross-functionally with our member growth team to streamline onboarding and ensure a seamless member experience.
Amae Health provides outpatient psychiatric and primary care health services through value-based care arrangements. They are a Series B venture-backed Public Benefit Corporation dedicated to becoming the nation's center of excellence for individuals living with severe mental illness.
Independently resolve a broad range of member inquiries across Maven Managed Benefits, fertility programs, and Maven Wallet workflows.
Interpret and clearly explain benefits design, eligibility, and coverage to members, identifying edge cases and ensuring alignment with plan rules.
Manage end-to-end reimbursement and payment workflows, including reviewing documentation, identifying discrepancies, guiding members on next steps.
Maven Clinic is the world's largest virtual clinic for women and families on a mission to make healthcare work for all. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Maven Clinic is a recipient of over 30 workplace and innovation awards.
Research and interpret state and federal reporting requirements.
Communicate changes to internal teams and customers.
Conduct quality assurance testing and compliance training.
Skyward builds software solutions for K-12 schools, helping students, teachers, and school administrators succeed. They foster a work environment with teamwork, enthusiasm, continuous improvement, and fun, offering opportunities for career growth.
Showcase customer service and data entry skills as part of the healthcare team.
Involved in claims adjudication and/or provider credentialing.
Support customers by phone, email and chat.
Sutherland helps customers globally achieve greater agility and transform automated customer experiences. As a digital transformation company they have been in business for over 35 years and are Great Place to Work certified with nearly 40,000 employees.
Gather, validate, and prepare data from multiple sources.
Identify missing or inconsistent fields and partner with Operations to resolve issues.
Zócalo Health is the first tech-driven provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, they are backed by leading healthcare and social impact investors.
Manages client denials and concerns through analytic review of clinical documentation.
Delivers final determination based on skillsets and partnerships with Humana parties.
Investigates and resolves member and practitioner issues via phone or face to face to support quality goals.
Humana Inc. is committed to putting health first for teammates, customers, and the company. Through Humana insurance services and CenterWell healthcare services, they strive to make it easier for millions to achieve their best health, delivering needed care and service.
Making outbound calls to patients, members, and customers.
Helping patients make decisions that will enhance their healthcare experience.
Assisting members and patients with benefits and insurance information.
Carenet Health pioneers advancements for experiences across the healthcare consumer journey, interacting with 1 in 3 Americans daily. They integrate human touch with data-driven technology to improve healthcare, offering best-in-class clinical expertise and personalized solutions.
Obtains authorizations from Insurance companies for scheduled tests/procedures.
Interprets patient medical records and reviews cases with the insurance nurse reviewer.
Accurately enters information into multiple computer programs and insurance websites.
CoxHealth is a leading healthcare system serving 25 counties across southwest Missouri and northern Arkansas. With six hospitals, 5 ERs, and over 80 clinics, CoxHealth has earned honors for workplace excellence and employs over 14,000 employees.
Support the onboarding process of new groups from application through to successful enrollment.
Work with customers on their annual benefits renewal process and any coverage or carrier changes.
Utilize phone, text, and email to provide proactive onboarding support and reconcile issues for customers.
SimplyInsured aims to alleviate concerns surrounding health insurance by providing transparent, accessible solutions to small business owners. With over 20,000 customers and key partnerships, they are rapidly expanding within the health insurance industry.
Develop comprehensive, complex, and accurate information reports.
Create complex data reports for forecasting and benchmarking used by senior management.
Communicate data findings directly to senior management.
Jobgether is a platform that uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against a role's core requirements. They identify the top-fitting candidates and share this shortlist with the hiring company.
Answer a high volume of inbound calls and chats from members, providers, and vendors.
Own the member's journey, including researching and resolving complex cases.
Explain all available benefits and help members understand their healthcare options.
Included Health delivers integrated virtual care and navigation. They break down barriers to provide high-quality care for every person, offering care guidance, advocacy, and access to personalized virtual and in-person care. They are an equal opportunity employer.
Execute payer enrollment applications from credentialing approval through payer confirmation.
Coordinate CAQH profile maintenance and attestations in alignment with Medallion workflows and payer requirements.
Track enrollment status, follow up with payers, and escalate delays or issues to the Payer Enrollment Manager.
Spring Health aims to eliminate barriers to mental health by delivering the right care at the right time through their clinically validated technology, Precision Mental Healthcare. They partner with over 450 companies and are valued at $3.3 billion.
Prepare and submit credentialing and enrollment packets.
Maintain accurate provider files and track expirations.
Provide assistance to the billing team during staff absences.
Modena Health and Modena Allergy & Asthma are leading medical practices specializing in allergy, asthma, and immunology care, with clinics across Southern California and Arizona and plans for national expansion. They are physician-led and technology-enabled, committed to transforming allergy care while advancing clinical research and expanding access to cutting-edge medicine.