Resolution Specialist Jobs in Union, Arkansas

Updates management on potential issues. Makes recommendations on resolution and ways to prevent future issues, after root cause evaluation

Minimum 2 years of experience in a finance, customer service or collection, or contracting background

Resolves escalated client issues/disputes using problem solving skills

Knowledge of Oracle ERP system is a plus

Bilingual (English /French (Canada)) is a requirement

Researches issues which includes contacting internal CDK business groups to determine resolution

This role is remote anywhere in the U.S.*

Bachelor's degree, or equivalent work experience

Four or more years of experience in administrative support activities

Demonstrated administrative skills and acute attention to detail

Strong verbal and written communication skills

Strong analytical and problem-solving skills

Skills needed: prior experience with queue-based casework, reporting, and identity verification

100% WFH/Remote – Must be located in the local Phoenix, AZ area

Job responsibilities include reviewing backgrounds, investigating background checks, and adjudicating processes

Opportunity for long-term career success and growth

Rewarding hard work and dedication

Access to a range of positions and career opportunities

Answercustomer service lines as necessary and responds toprovider inquiries either byphone, email,or in person regardingclaims-related questions.

Reviews, researches, and workswith various departments to resolve complex providerinquiries, appeals, and grievances.

ProcessesCIFs and adjustments as needed.

Writesand runsreports in Business Objects to obtain needed claim data.

Tracksand analyzesprovider trends with denials and CIFsto provide support toproviderswith an opportunity to improve.Distributesprovider scorecards.

Trackscomplaints, appeals, and grievances by the program. Reportsactivities on a quarterlybasis to IQI, PHC Compliance Coordinator,and Claims Director.

Handle all correspondence via mail, email and any necessary refunds; perform other duties as assigned by management

Strong computer skills. Basic understanding of MS Outlook, Word and Excel.

Experience in an environment where calls were monitored and scored as well as metrics applied to individual performance is helpful.

Excellent communication skills, both written and verbal. Able to present information and solutions in a professional and courteous manner.

Shift M-F 830am-5pm EST. Fully Remote. Work from the comfort of your home.

Review claims that have been put on hold, working to identify causes and address issues causing them to remain on hold

Works with clients, customers, and partners to accurately assess their needs, provide information or assistance, resolve problems, or satisfy requirements.

Complete all responsibilities as outlined on annual Performance Plan.

High School graduate or equivalent education.

1 year of related experience in healthcare collections or customer service strongly preferred.

Billing or coding experience preferred.

Requires working knowledge of and applicable industry-based standards.

Skilled at collaboration and relationship management through building trust, credibility and teamwork.

Aid Market Teams in the management of Emergency and Crisis situations as needed and directed.

Highly organized with experience prioritizing multiple functions and tasks while managing time efficiently without compromising quality

Workplace flexibility (for remote-specified positions only) #ABetterWaytoWork

Ensure that resolutions involving compensation are consistent and equitable based on unique circumstances and similar incident resolutions.

Facilitates the tracking, follow ups and timely resolution of all tasks.

1+ year of full time experience in a call center customer service environment preferred; remote work experience preferred

Must provide accessibility to secure, quiet work space with direct high-speed internet connection to effectively work remotely

Answer high volume, inbound phone calls from patients, utilizing a cloud based phone system.

Educate our patients on patient financial responsibility surrounding deductibles, copays, and coinsurance.

Confidently inform and collect patient balances using Privia financial policy guidelines.

Research, identify and resolve patient billing queries using athena EMR database.

This job may operate remotely.

Prior call center experience preferred.

Strong organizational and interpersonal skills.

Strong analytical and problem-solving skills.

Excellent phone skills with the ability to listen to others.

This job may operate remotely and/or in the office, based on the needs of the business.

Manage internal collection queue with varying stages of delinquency and past due balances.

Minimum of three (3) years collections experience in consumer or commercial collections.

General knowledge of collections regulations.

100% Remote. Flexible Work Schedule & Location.

Work From Home / Internet / Cell Phone Stipend.

Initiate contact with delinquent borrowers on a consistent basis via outbound call and email communications.

Working knowledge of Fair Credit Reporting Act requirements and Metro 2 guidelines

Four or more years of experience in clerical and customer service activities

Prior experience in credit analysis or lending

Prior experience working with credit reporting systems such as e-OSCAR

Superior knowledge of products, services, terminology, procedures and systems related to assigned area

Ability to manage multiple projects and deadlines simultaneously while maintaining a high level of customer service

At least 2 years of experience with the dispute management process for a fintech company, startup, or bank

Strong Microsoft Office or Google Workplace skills; ideally experience using Slack

Manage the end-to-end process of investigating card fraud and transaction disputes

Manage reporting to our banking partner and internal stakeholders

Interest in or experience with process improvement for back-office operations (ideally in a financial services environment)

Excellent written and verbal communication skills for interfacing with customers, vendors, and internal teams

Identify appropriate escalation points and work with direct manager to resolve issues

Prior experience in a role requiring communication with government caseworkers and hospital personnel

All Telecommuters will be required to adhere to Hiring Company’s Telecommuter Policy.

Monitor and foster ongoing communications with government agencies regarding the status of claims

Review inbox for daily work queues, identifies missing evidence and follows through to completion

Answer incoming calls from internal and external customers

Minimum of 3 years of experience in billing and collection management, preferably in healthcare

Insurance verification, claim submission, follow up, denial management and remit review

Communicate status of projects to team leader/manager on a daily or weekly basis depending on project requirements

Perform all denial management and collections procedures to obtain payment

Effectively prioritize and manage time to accomplish project goals and expectations

Bachelor's degree in Billing or related field, or equivalent experience

JOB REQUIREMENTS (Education, Experience, and Training):

Knowledge of general office operations and/or experience with standard medical insurance claim forms

Address counter-offers received and present proposal for resolution while adhering to client guidelines and policy and procedures

Provider education to providers online provider portal services available for proposal review and approval

Good Communication (verbal, written and listening) teamwork, negotiation and organizational skills

Ability to use software and hardware related to job responsibilities, including MS Word and MS Excel spreadsheets and database software

Experience in the finance or automotive industry

Knowledge of mechanical issues that commonly occur with vehicles

Experience having to interpret existing rules/guidelines and apply them appropriately to make decisions

Insightful by cultivating innovation, accumulating business and role specific knowledge, demonstrating self-awareness and making quality decisions

Targeted Compensation: $20.00- $23.00/hour based on experience.

Percent (%) of Customers contacted within 3 business days of escalation

At least one year of medical insurance or billing experience or equivalent training or education.

Maintains knowledge of current government and/or carrier regulations relevant to the industry.

Knowledge of medical insurance and its terminology.

Basic knowledge of ICD-10 and CPT codes.

Ability to work effectively in remote setting.

Serves as an active contributor in team meetings.

Computer Skills: Intermediate MS Suite knowledge and experience

Be knowledgeable in procedures, protocols, benefits, services, and any other necessary information to resolve member issues and inquiries

Support other projects and duties as assigned by Management

High school diploma or general education degree (GED); or equivalent combination of education and experience.

Experience helping members navigate their Medicare Advantage benefits including medical, prescription drug, and supplemental benefits

Minimum of 1-2 years healthcare experience and/or training required; 3-4 years of healthcare experience/training preferred

Strong communication skills (speaking - including presentations - listening, and writing)

Effective strategic planning capabilities, including the ability to establish long-term vision and goals, and

Ability to articulate a vision, set high standards

Demonstrate high levels of instructional expertise, integrity, honesty, credibility, and the courage to

Ability to build collaborative relationships with a variety of constituent groups, including external

Ability to define problems, analyze data, and outline valid conclusions and action steps

Training or knowledge of education law, particularly special education, and preferably student discipline, bullying and other mandated areas

Providing technical assistance and guidance to parents, advocates and school administrators on the implementation of regulatory requirements.

Strong interpersonal, communication skills – ability to communicate and work effectively with a wide range of constituencies in a diverse community.

An Equal Opportunity/Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

Performing other duties as required.

The successful candidate will possess: