Claims Relations Coordinator

Overview

Employer Industry: Managed Care Organization

Why consider this job opportunity:

• Salary range up to $67,210
• Flexible work-from-home options available for most positions
• Comprehensive health insurance with no premium for employee coverage
• Generous paid time off: 24 days of PTO plus 12 paid holidays in the first year
• Opportunity for professional growth within a mission-driven organization
• Supportive and collaborative work environment focused on making a positive impact

• Manage and coordinate claim issues received from providers, members, or other entities via various communication channels
• Ensure timely updates and responses to claims ticket queues and call logs
• Conduct thorough claims research, including reviewing claims processing systems and historical data
• Draft provider-related communications and assist with issue resolution
• Analyze trends in provider issues and recommend necessary updates for claims processing

• High School diploma/GED with at least six (6) years of relevant experience in a healthcare or public health setting, or an equivalent combination of education and experience
• Minimum of six (6) years of extensive medical claims research experience, including reviewing denials and analyzing claim reports
• Exceptional written and verbal communication skills for effective interaction with the provider community
• Must have a valid driver’s license and reside within North Carolina
• Ability to travel within the catchment area as required

• Degree in Business Administration, Healthcare Administration, Human Services, Public Administration, Liberal Arts, or Humanities
• Experience in the public mental health field is highly desired due to the complexity of the organization's work

#Managed Care #Healthcare Jobs #Remote Work #Career Growth #Claims Processing

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