Call Center Intake, Medical Claims, Mon-Fri 8am-5pm
Company: MultiPlan Inc.
Posted on: June 9, 2021
Imagine a workplace that encourages you to interpret, innovate
and inspire. Our employees do just that by helping healthcare
payers manage the cost of care, improve competitiveness and inspire
positive change. You can be part of an established company with a
40-year legacy that helps our customers thrive by interpreting our
client's needs and tailoring innovative healthcare cost management
Our commitment to diversity, inclusion and belonging are part of
the fabric of our company. We strive to create a workplace that
fosters mutual respect and collaboration, where every talented
individual can participate and perform their best work. We are
MultiPlan and we are where bright people come to shine!
JOB SUMMARY: This position is responsible for the handling,
research, and communication regarding complex and escalated claims
inquiries stemming from patients, clients, providers, and internal
customers', including both intake and resolution. In addition, this
position is also responsible for coaching and mentoring.
JOB ROLES AND RESPONSIBILITIES:
Investigate, analyze, research, and resolve complex and
escalated claim inquiries from patients, clients, providers, and
internal customers' as a result of issues related to discounts,
payments and balance billing. This includes handling legal
inquiries or department of insurance complaints.
Provide resolution and closure to the applicable recipients.
Create and execute business correspondence to clients or providers
using multiple media formats such as but not limited to emails,
form letters, and issues specific letters. This includes initiating
resolution and follow up calls to clients and providers.
Adhere to client turn around requirements as it relates to
response time and required actions.
Ensure investigative notes related to any contact with providers
and clients are documented and accessible throughout the applicable
Ensure the maintenance of and compliance with department
standards for production, accuracy, and turnaround time.
Perform system claim adjustments based on outcomes and
communicate with client regarding confirmation.
Assume and resolve escalated claim and inquiries from team
members. Serves as back-up for team members, or Leadership.
Coach and mentor less experienced team members on claims
handling, resource utilization, and appropriate resolutions.
May include call center responsibilities, including adhering to
call center standards.
Assist in training new team members as needed and providing
feedback to Leadership.
Various research projects for Sr. Management and Clients, as
Collaborate, coordinate, and communicate across disciplines and
Ensure compliance with HIPAA regulations and requirements.
Demonstrate Company's Core Competencies and values held
Please note due to the exposure of PHI sensitive data, this role
is considered to be a High Risk Role.
- The position responsibilities outlined above are in no way to
be construed as all encompassing. Other duties, responsibilities,
and qualifications may be required and/or assigned as
The incumbent works under minimal supervision to complete job
responsibilities in applying a fundamental knowledge of principles,
practices and procedures related to the servicing of inquiries and
providing resolution and follow-up, where necessary. Work is
complex and requires independent judgment within established
guidelines; however, may seek guidance from management as needed.
This job has regular contact with external and internal customers.
Individual may act as a primary contact for priority clients. While
this is not a supervisory job, an incumbent acts as a resource to
the Team and may provide input to management on training
JOB REQUIREMENTS (Education, Experience, and Training):
- Minimum completion of high school (i.e., diploma or GED)
- Minimum 3 years experience in the healthcare industry or
customer service, preferably with out-of-network claims.
- Required licensures, professional certifications, and/or Board
certifications as applicable.
- Bilingual English/Spanish may be required of some
- Knowledge of health care claims and appeal procedures .
- Knowledge of insurance company and medical service provider
- Communication (written, verbal and listening) problem solving,
interpersonal and decision-making skills.
- Ability to create and compose business correspondence
- Ability to multitask while setting priorities
- Ability to analyze data and arrive at a logical conclusion
- Ability to identify issues and determine appropriate course of
action for resolution
- Ability to elicit trust and credibility with all levels of the
- Ability to work with accuracy in a fast-paced environment
- Ability to adjust/alter workflow to meet deadlines
- Ability to work independently as well as part of a team
- Ability to handle confidential information.
- Ability to handle high pressure situations and variance in
- Ability to use software, hardware and peripherals related to
job responsibilities including MS Office
- Individual in this position must be able to work in a standard
office environment which requires sitting and viewing monitor(s)
for extended periods of time, operating standard office equipment
such as, but not limited to, a keyboard, copier and telephone
We realize that our employees are instrumental to our success,
and we reward them accordingly with very competitive compensation
and benefits packages, an incentive bonus program, as well as
recognition and awards programs. Our work environment is friendly
and supportive, and we offer flexible schedules whenever possible,
as well as a wide range of live and web-based professional
development and educational programs to prepare you for advancement
Your benefits will include:
- Medical, dental, and vision coverage (low copay &
- Life insurance
- Short- and long-term disability
- 401(k) + match
- Generous Paid Time Off
- Paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Summer Hours
MultiPlan is an Equal Opportunity Employer and complies with all
applicable laws and regulations. Qualified applicants will receive
consideration for employment without regard to age, race, color,
religion, gender, sexual orientation, gender identity, national
origin, disability or protected veteran status. If you'd like more
information on your EEO rights under the law, please [ Link Removed
Keywords: MultiPlan Inc., Irving , Call Center Intake, Medical Claims, Mon-Fri 8am-5pm, Other , Irving, Texas
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