Claims Operations Associate (Contract) New Job at Reliance Health, Remote

ay95cDMxZHlET3ZzTUxkRGpTZUR4dEt0MUE9PQ==
  • Reliance Health
  • Remote

Job Description

The Claims Operations Associate is responsible for managing claims and approvals processes, and the scope of work includes vetting health insurance claims and approval from service providers, reconciling payments and negotiating and uploading claim tariffs.

Key Responsibilities

  • Examine and approve or reject healthcare providers’ claims to meet set targets.  

  • Investigate claims for fraud, waste, and abuse.  

  • Promptly resolve escalated approval requests for care.  

  • Negotiate tariffs and update the providers’ dashboard and execute other elements of tariff management.  

  • Collaborate with the technology team to improve the processes claims, tariff and approvals management system.  

  • Collaborate with customer success and provider relations teams to ensure customer satisfaction goals.

Requirements

  • Minimum of a first degree in medicine, nursing or pharmacy and completion of internship or houseman ship.  

  • Previous experience in a claim examiner role is a major advantage.  

  • Excellent numeracy, analytical and problem-solving skills.  

  • A high-level of responsiveness is essential and openness to working shifts including occasional weekends.  

  • Strong medical and clinical knowledge and experience.  

  • Excellent interpersonal and communication skills. 

  • Renumeration: 250k - 300k

Benefits

  • Join a market leader within the Insurance space

  • Unlimited leave days

  • Fantastic work culture

  • Work and learn from some of the best in the industry

  • Great work-life balance

Job Tags

Remote job, Contract work, Internship,

Similar Jobs

PROTOCOOL Cooling Solutions

HVAC Maintenance Professional Job at PROTOCOOL Cooling Solutions

Are You An HVAC Maintenance Professional Who Wants To Work For A Thriving Company Where You Can Grow, Be Recognized, And Be Rewarded For Your Work?Stop Working At A Job That You Hate. Work With Friends In An Environment That Rewards You For Your Hard Work And Provides... 

West Frankin Investments

Independent Route Delivery Contractor - Belmont, New Hampshire Job at West Frankin Investments

 ...Independent Route Delivery Contractor Belmont, New Hampshire Service Area: Belmont, NH 03220 Position Type: Independent Contractor (1099) Daily Pay: $100 per route day Start Date: Immediate West Franklin Investments LLC is seeking dependable, self-motivated... 

MH Energy

Class A Water Hauling to the Oil Fields Job Job at MH Energy

Class A Water Hauling to the Oil Fields JobWater hauling to the oil fields, local routes. Pay: $91,500 - $102,750 Annual. Hourly pay plus overtime after 40 hours. Raise after 90 days.Employee and family health benefits, retirement package, newer trucks, double pay... 

Senior Helpers - Boise/Treasure Valley

Corporate Pilot with AgingCare Do Not Delete Job at Senior Helpers - Boise/Treasure Valley

There is a reason Senior Helpers has been recognized as a Great Place to Work for the THIRD year in a row! Senior Helpers is the FIRST in-home care provider to be ranked by the Great Place to Work Institute as a Great Place to Work. Our caregivers and staff are met with...

American Income Life

Remote Benefits Customer Care Agent Job at American Income Life

 ...Remote Leadership Opportunity Work From Home | Flexible Schedule | Mentorship Provided Are you a motivated professional ready to leadwithout sacrificing flexibility or work-life balance? Were seeking driven individuals to join our growing remote team in a leadership...