Modivcare
Modivcare
„Modivcare“ yra sveikatos priežiūros paslaugų įmonė, padedanti žmonėms valdyti sudėtingus priežiūros poreikius teikiant ne skubų medicininį transportą, asmeninę priežiūrą, virtualų ir nuotolinį pacientų stebėjimą, lėtinių ligų priežiūros koordinavimą, maisto pristatymą ir pagalbą namuose. Jos paslaugos skirtos „Medicaid“ ir „Medicare Advantage“ planams, valstijų institucijoms, sveikatos priežiūros sistemoms, sveikatos priežiūros specialistams ir transporto paslaugų teikėjams. Derindama technologijas, duomenis ir koordinuotą pagalbą, „Modivcare“ siekia spręsti sveikatai įtaką darančius socialinius veiksnius, padėti nariams gauti būtinas paslaugas ir užtikrinti nenutrūkstamą priežiūrą.

Claims Analyst III

Modivcare is hiring a remote Claims Analyst III in the United States to audit claims, resolve payment discrepancies, and improve claims systems. The role handles complex claim issues and includes mentoring junior team members.

Aprašymas

  • Put claims processes in place to improve efficiency and accuracy
  • Check claims data entered into the system for accuracy
  • Track claims system performance
  • Resolve claims issues and work with systems design teams to implement new features
  • Check claims for irregularities, accuracy, and completeness
  • Request any additional information needed to process claims
  • Manage documentation, invoice disputes, and account payments
  • Analyze accounts and investigate payment or account discrepancies
  • Verify transactions and speed up claims issue resolution
  • Resolve complex issues, escalating only the most difficult cases to higher-level staff
  • Guide, coach, and mentor junior team members
  • Take part in other projects and duties as assigned

Reikalavimai

  • Bachelor’s degree, or an equivalent combination of education and experience
  • More than five years of experience
  • Strong knowledge of claims processing and sound judgment when assessing claim eligibility
  • Careful attention to detail and accurate data entry skills
  • Intermediate skills with Microsoft Word, Excel, and Outlook
  • Analytical ability to interpret claim data and follow established guidelines
  • Strong verbal and written communication skills with a customer-focused approach
  • Problem-solving skills to address claim issues and resolve discrepancies
  • Ability to work both independently and as part of a team
  • Typing speed of at least 35 words per minute and 10-key proficiency

Privalumai

  • Medical, dental, and vision insurance
  • Employer-paid basic life insurance and accidental death and dismemberment coverage
  • Voluntary life insurance for employees, spouses, and children
  • Health care and dependent care flexible spending accounts
  • Pre-tax and post-tax commuter and parking benefits
  • 401(k) retirement savings plan with company match
  • Paid time off
  • Paid parental leave
  • Short-term and long-term disability coverage
  • Tuition reimbursement
  • Employee discounts on retail, hotels, food, restaurants, car rentals, and more

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