PPO Repricer I

Highmark Health • Blue Bell, PA

1d • Hybrid

About The Position

HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. This role is based in Blue Bell, PA - the role will work from home the majority of the time however this role will also be the backup for the mail room as well and will need to go onsite to the Blue Bell office during that time.

Requirements

• Required Education: HS/GED
• Required Experience: Knowledge of claims terminology is preferred.
• Required Knowledge/Skills: 1. Knowledge of insurance or claims terminology and ability to work in a fast paced production environment 2. Excellent communication skills both verbal and written 3. Organizational skills and detail oriented 4. Computer experience 5. Excellent decision and judgment skills 6. Ability to work independently and with the team
• Required Licenses/Certifications:
• Problem Solving Ability to research and seek assistance through resources provided to insure resolution on repricing issues or correspondence is completed.
• Must be able to multi-task and follow-up at appropriate intervals.
• Raise concern with management on workload or issues in a timely manner.

Responsibilities

• Process PPO workload assigned.
• Maintain production and quality standards.
• Monitor workflow reports to insure backlog is current and jobs are appropriately prioritized.
• Maintain knowledge of standard operating procedures.
• Provide excellent communication and service with membership, clients, PPOs, management, peers and other areas within the organization.
• Work with external PPOs and claims staff to resolve PPO repricing issues.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees