Post Payment Claims Review Coordinator Jobs

Actively manages and escalates risk and customer-impacting issues within the day-to-day role to management.

8:00 AM - 3:00 PM EDT (OH, DE, NJ, MD, PA)

6:00 AM - 1:00 PM MDT (UT)

5:00 AM - 12:00 PM MST (AZ)

Processes late and trailing transactions on fraud status accounts and processes zero fraud loss cases.

Updates information from merchant receipts to the case information screen.

Skilled in relationship management and able to successfully work with both internal and external stakeholders.

4 years of directly related multifamily underwriting and credit experience.

Prior experience managing risk in the Multifamily space.

Skilled in governance and compliance to include creating policies, evaluating compliance, developing data governance, etc.

Excellent communication skills. Can explain concepts, answer critical questions, and frame ideas as systems, inputs, outputs and processes.

Strong influencing skills to include negotiating, persuading others, facilitating meetings, and resolving conflict.

Manages incoming manual claims from multiple clients to our secure server

Other responsibilities or projects as assigned

3-5 years of healthcare experience

Excellent verbal and written communication skills

Strong internal and external communication skills, both verbal and written

Must be able to operate computers and phones to support position requirements

Knowledge of medical plans and benefits. Requires basic job knowledge of systems and procedures obtained through prior work experience or education

Requires broad knowledge of operational systems and practices typically gained through extensive experience and/or education

Requires minimum of 5 years of experience. May require vocational or technical education in addition to prior work experience

Requires extensive experience in claims processing

Intermediate-Advanced skills creating documents/files using Excel, Outlook, Power Point, and Word

Process multiple claim types or specialties

Enter design details into content management software including data entry, downloading, and attaching source documents

Experience in an analytic role collecting, querying, reporting, analyzing, and presenting data; preference in healthcare, accounting, or corporate finance setting

Comfortability using Jira, Google Apps (Google Docs, Google Sheets), Notion, Slack, and Content management software.

Ability to quickly learn business-specific software (e.g., project management, document creation)

Work closely with a team of experts with extensive medical claims experience

Utilize strong coding and industry knowledge to research regulatory updates, create and maintain editing content (data used by the edits)

Communicate with members, providers and/or external organizations regarding appeals status or questions. Address critical inquiries from senior management through research.

Associate Degree or 2 years of job related work experience.

3 years of experience processing, researching and adjudicating claims.

Subsidized health plans, dental and vision coverage

401K retirement savings plan with company match

On-site cafeterias and fitness centers in major locations

Intellectual disability and related disabilities

intellectual disability and related disabilities

A high school diploma and two (2) years of relevant program experience.

Spinal cord injury and similar disability

spinal cord injury and similar disability

This posting seeks to fill three (3) vacancies.

Intellectual disability and related disabilities

intellectual disability and related disabilities

Spinal cord injury and similar disability

spinal cord injury and similar disability

This posting seeks to fill three (3) vacancies.