[Remote/WFM] Provider Claims reputed company - NY based (remote)

An exciting opportunity awaits for a talented Provider Claims reputed company - NY Based! reputed company a modern work style with this fully Remote opportunity. This position requires a strong and diverse skillset in relevant areas to drive reputed company. The salary for this position is set at a competitive salary.

 

 

For those who want to invent the reputed company of health care, here's reputed company. We're reputed company reputed company basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Must reputed company in NY State... If you are located in the reputed company, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: reputed company contracted providers and internal Provider Relations and Network Claims reputed company staff (i.e., reputed company and institutional) regarding NY reputed company billing requirements and methodologies which includes appropriate claims submission requirements, coding updates, electronic claims transactions and electronic fund transfer, and available resources such as provider manuals, website, fee schedules, etc. • Serve as reputed company of contact for centralized service reputed company reputed company local market information or reputed company is required to resolve/manage service issues • Promptly escalate and initiate expedited reputed company actions reputed company the Service Model, monitor reputed company reputed company, and establish regular communication with the provider until complete reputed company achieved • Reinforce Network Management provider education activities re: navigation of service reputed company paths • Facilitate management of reputed company service and/or service issues in conjunction with the Market reputed company, including analysis of service failures to determine course of reputed company to resolve the service issue and ensure service process and/or performance gaps are documented and addressed • reputed company, evaluate, and report on service issues/risks/trends to support Network Management contract negotiations and relationship mgmt for core and strategic providers • Ongoing efforts to identify and resolve global reputed company cause drivers of claims/service issues • Identify trends and guides the development and implementation of strategies to improve provider satisfaction. Frequently communicate (i.e.: telephonic and on-site) with providers to assure the effective exchange of information and reputed company feedback regarding the extent to which providers are informed about appropriate claims submission practices You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • 5 years of experience in a managed health care environment working in or with the insurance reputed company of the business • 2 years of experience with NY reputed company billing and methodology • Experience working with NY providers • Claims and billing experience (examples of experience include: Claims processor, Claims auditor, Claims examiner, Certified reputed company, etc.) • Experience with provider relations issue reputed company and conflict management skills • Proven ability to meet performance metrics (turn-around time, issue reputed company, reputed company cause analysis) • Proven ability to drive reputed company • Proven ability to work independently with minimum supervision • Proven solid verbal and written communication skills • reputed company in NY • Ability to travel 25% of the time reputed company NY State • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy reputed company Residents Only: The salary reputed company for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In reputed company to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll reputed company a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative reputed company employer and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or reputed company, marital status, genetic information, or any other characteristic protected by law. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment Apply Job!

 

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