Benefits Coordinator

  • location: New York, NY
  • type: Permanent
  • salary: $50,000 - $55,000 per year
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job description

Benefits Coordinator

job summary:
Our client is seeking a detail oriented Benefits Coordinator to join their team.

Salary: $55k ($70k total package with Benefits)

  • Act as a trusted resource for complex claims and benefit questions and issue resolution.
  • Act as a liaison to our health plan partners and providers in solving complex claims and benefit issues.
  • Educate AHAs by helping them better understand claims and benefit questions/issue resolution, and support ongoing training/learning with the Health Assistant Center (HAC).
  • Collaborate with Accolade teammates, health plans, and providers to deliver the best possible service experience for Accolade clients.
  • Handle claim disputes with partner health plans on behalf of the client

    • Ensure compliance with internal and external health plan partner business processes.
    • Develop and maintain solid working relationships and processes with health plans and other payors.
  • Support AHAs with eligibility, benefits, and claims questions and/or issue resolution, including understanding the root cause of the issue Handle claims disputes with partner health plans on behalf of the client. Handle claim disputes with partner health plans on behalf of the client

    • Listen, assess, and comprehend the clients' presenting issue(s) and use critical thinking, judgment, and problem solving to take appropriate action.
  • Identify opportunities to improve how we resolve claims and benefit issues, including improvements to MRM (our customized service platform), our benefit content, and other tools and resources.
  • Leveraging your industry knowledge and influencing skills, encourage future collaboration with health plans and providers.
  • Participate in special projects as requested
  • Provide colleagues with timely and accurate solutions to their client's complex claims problems.
  • Effectively manage an ongoing portfolio of claims/benefits issues, ensuring timely, complete and accurate resolution in support of client expectations and health plan processing guidelines.
Qualifications

What we are looking for...

  • A thorough understanding of health care delivery and previous experience with medical benefits (primarily self-insured plans) and claims from either provider or payor perspective.

    • Health Plan or third party payor claims processing experience with strong technical skills (business expertise) and knowledge of various lines of business and applicable coding (CPT, HCPCS, ICD-9/10, DRG, etc.)
    • Health Plan business/benefit analyst with an emphasis on claims coding (see above line) and benefit set-up
    • Health Plan claims quality assurance
    • Practice Management or Hospital -Familiar with all bill types and national account billing
  • Engage others by being a good listener with a solid capacity for empathy.
 
location: New York, New York
job type: Permanent
salary: $50,000 - 55,000 per year
work hours: 9 to 5
education: Unknown
experience: 3 Years
 
responsibilities:
  • Act as a trusted resource for complex claims and benefit questions and issue resolution.
  • Act as a liaison to our health plan partners and providers in solving complex claims and benefit issues.
  • Educate AHAs by helping them better understand claims and benefit questions/issue resolution, and support ongoing training/learning with the Health Assistant Center (HAC).
  • Collaborate with Accolade teammates, health plans, and providers to deliver the best possible service experience for Accolade clients.
  • Handle claim disputes with partner health plans on behalf of the client

    • Ensure compliance with internal and external health plan partner business processes.
    • Develop and maintain solid working relationships and processes with health plans and other payors.
  • Support AHAs with eligibility, benefits, and claims questions and/or issue resolution, including understanding the root cause of the issue Handle claims disputes with partner health plans on behalf of the client. Handle claim disputes with partner health plans on behalf of the client

    • Listen, assess, and comprehend the clients' presenting issue(s) and use critical thinking, judgment, and problem solving to take appropriate action.
  • Identify opportunities to improve how we resolve claims and benefit issues, including improvements to MRM (our customized service platform), our benefit content, and other tools and resources.
  • Leveraging your industry knowledge and influencing skills, encourage future collaboration with health plans and providers.
  • Participate in special projects as requested
  • Provide colleagues with timely and accurate solutions to their client's complex claims problems.
  • Effectively manage an ongoing portfolio of claims/benefits issues, ensuring timely, complete and accurate resolution in support of client expectations and health plan processing guidelines.
 
qualifications:
What we are looking for...

  • A thorough understanding of health care delivery and previous experience with medical benefits (primarily self-insured plans) and claims from either provider or payor perspective.

    • Health Plan or third party payor claims processing experience with strong technical skills (business expertise) and knowledge of various lines of business and applicable coding (CPT, HCPCS, ICD-9/10, DRG, etc.)
    • Health Plan business/benefit analyst with an emphasis on claims coding (see above line) and benefit set-up
    • Health Plan claims quality assurance
    • Practice Management or Hospital -Familiar with all bill types and national account billing
  • Engage others by being a good listener with a solid capacity for empathy.
 
skills: Administration
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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