[Hiring] Claims Data Coordinator @Claritev

Role Description

This position supports the department by reviewing, researching, and preparing incoming client and provider submissions for next steps as it relates to No Surprise Act. Position will perform a variety of administrative duties to ensure proper processing of information timely and accurately to maintain departmental quality and turnaround requirements.

• Analyze email and/or portal submissions to create cases, attach appropriate documentation, populate applicable required system fields, prepare submission accordingly for next steps.
• Perform timely data entry in all applicable systems and perform timely outreach to providers and/or clients to obtain necessary information.
• Perform claim and system research and determine next steps for appropriate routing, which may include adjustment of medical claims.
• Log information derived from written and verbal communications using detailed and accurate documentation.
• Meet required production and quality standards.
• Provide excellent customer service and strive to continuously improve service delivery according to departmental and corporate guidelines and principles.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company's Core Competencies and values held within.
• Please note due to the exposure of PHI sensitive data -- this role is considered to be a High-Risk Role.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

Qualifications

• Minimum High School Diploma or GED.
• Minimum 1 year experience in healthcare environment required, experience with medical claims processing highly desired.
• Knowledge of word processing and spreadsheet software, MS Office, required.
• Excellent communication, organization, and attention to detail skills.
• Ability to follow through and work under deadlines.
• Service oriented, flexible, and ability to work under pressure.
• Works well in both individual and team environments.
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone.

Benefits

• Medical, dental, and vision coverage with low deductible & copay.
• Life insurance.
• Short and long-term disability.
• Paid Parental Leave.
• 401(k) + match.
• Employee Stock Purchase Plan.
• Generous Paid Time Off – accrued based on years of service.
• WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service.
• 10 paid company holidays.
• Tuition reimbursement.
• Flexible Spending Account.
• Employee Assistance Program.
• Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits.

Company Description

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!