Independent Dispute Resolution Rep
About The Position
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for intake, processing, coordinating all materials and information relating to processing negotiations and independent disputes as regulated by federal or state regulations. This applies to all plans at HCSC, all lines of business and all products. Additionally, this position will accurately process and respond according to the HCSC procedures via the required notifications and provider resolution. This includes entry of new requests via the appropriate database.
Requirements
- High School Degree or GED.
- Analytical, problem solving and research skills.
- Organizational skills to accommodate large volume of reference materials combined with time management skills.
- Verbal and written communication skills to clearly express oneself; exercises diplomacy.
- Experience working both independently and in a team environment to meet deadlines according to regulations
- 1 year experience in a customer service role OR in a health insurance or medical environment.
- Experience and skills to analyze and assist the provider based on knowledge of federal, state guidelines.
- Experience and skills to organize tasks and accommodate large volume of reference materials.
Nice To Haves
- BlueChip claims payment experience.
- Medical terminology.
- Ability to think clearly and maintain a professional, poised attitude under pressure.
- Detail oriented.
- 2-year experience processing claims and utilizing a claims payment system.
Responsibilities
- intake
- processing
- coordinating all materials and information relating to processing negotiations and independent disputes as regulated by federal or state regulations
- accurately process and respond according to the HCSC procedures via the required notifications and provider resolution
- entry of new requests via the appropriate database
Benefits
- health and wellness benefits
- 401(k) savings plan
- pension plan
- paid time off
- paid parental leave
- disability insurance
- supplemental life insurance
- employee assistance program
- paid holidays
- tuition reimbursement
- annual incentive bonus plan
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
