Temporary Out of Network Customer Specialist

Published
October 17, 2020
Location
Newtown Square, PA
Category
Job Type

Description

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company that helps our customers thrive by interpreting our client's needs and tailoring innovative cost management solutions.

We are MultiPlan and we are where bright people come to shine!

This position is a temporary position and will begin in a work from home capacity. Once the Newtown Square, PA office reopens, the position will shift to an in-office position and the incumbent will be expected to work out of the Newtown Square office.

The Temporary Customer Out of Network Specialist is responsible for research, resolution and communication of patient, client, provider and internal customer inquiries and any follow-up required thereafter.
JOB ROLES AND RESPONSIBILITIES:
1. Investigate, analyze, research, and resolve claim inquiries as a result of issues related to discounts, payments and balance billing.
2. Provide resolution and closure to the applicable recipients. Create and execute business correspondence to clients or providers using multiple media formats.
3. Defend and uphold discounts that providers have previously accepted to prevent balance billing or reversals, including re-education.
4. Ensure investigative notes related to any contact with providers and clients are documented and accessible throughout the applicable systems.
5. Adhere to client turn around requirements as it relates to response time and required actions.
6. Ensure the maintenance and compliance with department standards for production, accuracy, and turnaround time.
7. Perform system claim adjustments based on outcomes and communicate with client regarding confirmation.
8. Serve as liaison between Claims Specialists, Client Service Representatives, and client contacts as needed.
9. May include call center responsibilities, including adhering to call center standards.
10. Collaborate, coordinate, and communicate across disciplines and departments.
11. Ensure compliance with HIPAA regulations and requirements.
12. Demonstrate Company's Core Competencies and values held within.
13. Due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
14. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
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