Digital Resolution Specialist

Responsibilities

• Respond to written inquiries from members, providers, and brokers via the web portal or departmental Outlook email addresses
• Outbound calling, as needed, to provide further member support or meet the requirements of the request
• Research, document, and resolve all inquiries within outlined turnaround times
• Describe medical and dental benefits according to group contracts
• Provide claim status, including the accurate explanation of patient financial responsibility, ineligible amounts, and plan payments
• Resolve written complaints
• Provide information to employees' regarding their Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), and Health Reimbursement Accounts (HRAs)
• Assist claimants with prescription drug plan program
• Cook up claim review information with the claims department
• Request stop pays/tracers
• Receive and coordinate appeal requests with appropriate parties
• Afford assistance to collectors in reconciling patient accounts

Requirements

• A High School Diploma or GED
• Some college
• 1+ year of healthcare related work experience
• Customer service call center experience

Qualifications

• Computer skills proficient in Microsoft Outlook, Word, Excel, and internet navigation

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Pay

Not specified

Schedule

100% remote