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Resolution Specialist- Medical Claims- Remote - Work From Home

Richmond, Virginia Jobs

23223 Jobs

Change Healthcare Jobs

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call center

customer service

$104,949 - $128,271

Resolution Specialist – Medical Claims- Remote

Overview of Position

This position is responsible for providing high quality client focused service by using knowledge of local, state, and federal program requirements to efficiently maintain and update general applicant information, financial, medical and personal information to support client applications.

What will be my duties and responsibilities in this job?

  • Monitors and fosters ongoing communications with government agencies regarding the status of claims.

  • Documents and updates internal database based on daily contact of select members of assigned applicant group and application evidence requirements, i.e., work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.

  • Reviews inbox for daily work queues, identifies missing evidence and follows through to completion.

  • Answers incoming calls from internal and external Customers.

  • Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process.

  • Effectively educates and answers inquiries from patients and family representatives regarding application process.

  • Assists clients with scheduling appointments and reminding of appointments, as needed.

  • Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process.

  • Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval.

  • Identifies appropriate escalation points and works with direct manager to resolve issues.

  • Reviews outgoing client material for accuracy prior to submittal.

  • Complies with ethics, privacy and compliance policies and procedures.

What are the requirements needed for this position?

  • High School diploma or equivalent; Associates degree preferred

  • Computer skills, including MS Excel and basic keyboard skills required

  • 1+ yrs. experience in call center, claims or customer service

    What other skills/experience would be helpful to have?

  • Fluency in both English and Spanish languages helpful

  • Ability to apply knowledge of federal and state programs to benefit coverage for the client

  • Strong communication skills (verbal & written); demonstrated experience working with people of various educational, experience communicating government caseworkers and hospital personnel

  • Strong organization skills – ability to prioritize, plan

  • Ability to work independently and follow tasks through to completion without direct supervision

  • Understanding of state and federal benefits

Work Environment and Schedule:

  • Work-from-home, quiet workspace needed, high speed internet required (no satellite internet)

  • Fulltime, 40 hours weekly. Monday through Friday, an 8-hour schedule between 7am and 6pm EST

    Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

    COVID Vaccination Requirements

    We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

    Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to ***** with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) .

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

Job ID: 6837367519934767723



Resolution Specialist- Medical Claims- Remote - Work From Home

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This job is located in

Richmond, Virginia, 23223