San Juan, PR, 00918, USA
20 hours ago
Carrier Services Coordinator
**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You’ll Be Doing:** We believe in the power of partnerships to help people navigate their care with less friction, frustration, and fear. And that every person deserves the same level of case and compassion we would want for our loved ones. We also believe that trust must be earned every day, in every interaction, through productive, collaborative relationships with physicians and payers, and that nothing builds trust like delivering better health outcomes. **Collaboration Opportunities:** Joining the Carrier Services Team would provide the candidate with the stability, knowledge, and ability to help not only our external customers but internal customers as well by providing superior service and support. Our team focuses on collaboration, a team-oriented environment, as well as continual learning to have a better understanding of the company as a whole and will offer as provide opportunities for continual growth. **What You Will Be Doing:** + Acts as liaison for assigned health plan regarding the accurate and timely submission of claims/statements. + Works with management to obtain corporate financial goals and objectives specific to assigned health plan. + Acts as Subject Matter Expert on the contract for their assigned health plan, particularly billing requirements and reviews pricing to ensure accuracy. + Follows-up with assigned health plan and other team members to verify quick and accurate workflow for minimum (DSO) Days Services Outstanding. + Ensures completion or receipt of all documents needed for billing and all other documents, as appropriate. + Checks all billing for assigned health plan, line by line, to make sure that the claim is billed to the proper payer source, in the proper billing format, with the appropriate codes and quantities. + Submits the necessary admission notices to payers/providers on a daily basis. + Maintains billing files on all assigned patients and generates billing statements to payers and customers in a timely manner. + Researches and resubmits claims without response or denied in established time frame. + Resolves billing payment problems in detailed organized fashion focusing on the company’s standard for DSO. + Documents contacts with outside individuals on billing issues. + Informs Manager of problem accounts promptly. + Performs schedules hours, staggered shifts in accordance with the needs of the company. + Handles healthcare professional calls that may involve resolving conflicts and/or the completion of information professionally. + May perform other duties not specifically listed in this position description as assigned by supervisor. **What You Bring:** + 2+ years of experience in healthcare collections is required. + Strong analytical skills, excellent verbal, written, and interpersonal communication skills. + Fluent with all Microsoft Office applications. + Ability to work quickly and accurately on an independent basis; giving great attention to detail and displaying the initiative to quickly identify and resolve variances and discrepancies + Strong problem solver and skilled in conflict resolution. + Strong listening and questioning skills. + Works well in a team environment. **To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.** **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** **recruiting@evolent.com** **for further assistance.** The expected base salary/wage range for this position is $18.00-21.00/hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
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