Phone Claim Analyst (Supplemental Health) – Remote

Benefits

• 401(k)
• Paid time off

Location: Various Locations
Work Type: Full Time Regular
Categories: Customer Service, Claims/Claims Processing
Application Closes: Open Until Filled
The Cancer Hospital Claims Department has immediate openings for a Phone Claims Analyst to ensure the accurate, prompt, and thorough evaluation of claims by analyzing and determining the appropriate action steps needed while adhering to both internal and external regulations and ensuring an industry leading customer experience. This position is a phone based position where a majority of your time is spent on inbound and outbound calls.

Ensures the accurate, prompt, and thorough evaluation of claims by analyzing and determining the appropriate action steps needed while adhering to both internal and external regulations and ensuring an industry leading customer experience.

Requires independent decision making on claims situations using some critical thinking. Claim analysis includes: eligibility determination for benefits based on information received, contract analysis, customer service, fraud detection and awareness, some financial calculations, interpreting information and adhering to all statutory/governmental regulations. This includes analyzing information received, and determining if additional information is needed to make an accurate benefits decision.

Embraces the customer-focused strategy and demonstrates our shared values (Customer Focus, Integrity, Innovation, Accountability, and Collaboration) by providing effective customer service resulting in first request resolution and a positive customer experience.

Training class starts on Friday, September 22nd!

Training will be up to 6 weeks Monday - Friday from 8am - 4:30pm CST.
The hours after training will be Monday - Thursday from 9am - 5:30pm CST and Fridays from 8:30am - 5pm CST.

WHAT WE CAN OFFER YOU:

• Hourly Wage: $19.00/hr, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
• Regular associates receive 9 paid holidays in 2023.
• Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 56 hours of personal time in 2023, prorated based on the start date.

WHAT YOU'LL DO:

• Accurately determines claim benefits payable based on medical information and contract language in a timely and accurate manner.
• Reviews and analyzes claim documentation, correspondence, and provider information to identify changes, additions and deletions. Verify all information conforms to established policies and procedures; ensure that provider data adheres to Corporate guidelines for file integrity and reporting purposes while maintaining production, quality and time service standards.
• Communicates with external and internal customers to obtain specific claim information in order to finalize claims and to explain claim handling, whilst meeting and exceeding customer expectations and cultivating relationships that secure commitment and trust.
• Provides effective customer service via multiple channels such as phone (to include inbound and outbound calls), written/email correspondence, etc. Performs service recovery techniques to resolve requests. Provides compliant and easily understood resolution options with the desired outcome of creating a positive customer experience. Utilizes resources to support service delivery resulting in retaining and/or growing the business.
• Identifying and understanding problems and opportunities by gathering, analyzing, and interpreting quantitative and qualitative information; choosing the best course of action by establishing clear decision criteria, generating, and evaluating alternatives, and making timely decisions; taking action that is consistent with available facts and constraints and optimizes probable consequences.
• Taking prompt action to accomplish work goals; taking action to achieve results beyond what is required; being proactive. Meets and/or exceeds department standards related to attendance, productivity and quality.
• Maintaining effectiveness when experiencing major changes in work responsibilities or environment (e.g., people, processes, structure, or culture); adjusting effectively to change by exploring the benefits, trying new approaches, and collaborating with others to make the change successful.

WHAT YOU’LL BRING:

• Shows a sense of urgency and is accountable for work results. Effective time management and organizational skills with an attention to detail and analytical and decision-making abilities
• Ability to work independently, and/or as part of a team, in a collaborative environment and is approachable.
• Effective oral, written and interpersonal communication skills, sound judgment and the ability to think within a structured and compliant work environment while focusing on the customer.
• Working understanding of computer systems such as email, data entry, and Microsoft products, with proficient keyboarding skills.
• Ability to work flexible shifts and maintain regular and predictable attendance with adherence to department and company attendance expectations. May be required to work overtime based on business needs.
• Ability to assess and understand the needs of the customer and demonstrates flexibility in customizing approach and response to resolve requests in a respectful and timely manner.
• You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

VALUABLE EXPERIENCE:

• Insurance product knowledge.
• Experience with the application of policies, practices and procedures in a business environment.
• Knowledge of medical terminology.

We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply!

After applying, for inquiries about your application or the hiring process, please call our helpline at 800-365-1405, option 2.

Help: 800-365-1405