Carrier Claims Liaison

International SOS•Bensalem Township, PA

41d

About The Position

The Carrier Claims Liaison submits accurate, clean claims to insurance carriers in compliance with carrier-specific guidelines and procedures. The role generates accurate cost-share invoices for civilians based on carrier reimbursement details and supports accounts receivable by researching unpaid claims, preparing appeals for denied claims, and following up to achieve timely and favorable claim resolution. The position reviews and extracts medical claims from the BiGGeR system, generates system invoices, prepares invoice packages, and submits claims according to established carrier billing procedures. It maintains an internal invoice-tracking database, tracks carrier reimbursement details for the provider payment team, and works with insurance carriers and internal teams to resolve unpaid, denied, or partially paid claims. It also prepares patient cost-share invoices and uploads invoicing data to SharePoint for collections review. The liaison communicates timely, factual updates to supervisory and management teams, applies insurance carrier reimbursement processes to explanation of benefits (EOBs), and safeguards private health and personal information in accordance with HIPAA and PCI compliance regulations. The role participates in office activities, meetings that may occasionally occur after normal business hours, and process-improvement task forces, and performs related duties assigned by the Claims Support Manager.

Requirements

At least two years of work experience with insurance carrier billing and collections.
Experience with medical billing and collections.
Proficiency in Microsoft Office applications, including Excel, Word, Outlook, and PowerPoint.
Works well under pressure.
Team player.
Attention to detail.
Excellent communication skills.
Must be authorized to work in the country of employment without current or future employment-based visa sponsorship.

Responsibilities

Review and extract medical claims recorded in the BiGGeR system daily, generate system invoices, prepare comprehensive invoice packages, and submit clean claims according to carrier billing procedures.
Maintain and update the internal invoice-tracking database with submitted invoices and related data.
Track insurance carrier reimbursement details and relay the information to the provider payment team.
Work with insurance carriers and internal Operations, Claims Management, Provider Payment, and Accounts Receivable teams to resolve unpaid, denied, or partially paid claims.
Generate patient cost-share invoices and upload invoicing data to SharePoint for Collections Team review and processing.
Communicate timely and factual updates to supervisory and management teams regarding matters that may affect data integrity, productivity, or efficiency.
Apply insurance carrier reimbursement processes for EOBs and accurately record the information in the internal invoice-tracking database.
Protect private health and personal information by complying with HIPAA and PCI requirements for billing and reimbursement data.
Participate in day-to-day office activities, meetings that may occasionally take place after normal business hours, and process-improvement task forces.
Complete additional related duties assigned by the Claims Support Manager.