[Hiring] Copay Claims Processor @TailorMed

Role Description

The Copay Claims Processor is a member of the TailorMed Complete team and serves as an extension of our customer’s internal teams. In this role, you'll help improve financial outcomes for patients by using our platform to submit claims on the patient’s and provider’s behalf to the approved manufacturer or foundation copay program, and for our customers by helping them improve their financial performance as an organization.

• Ability to review pending claims thoroughly in detail to ensure accuracy
• Submit copay claims through appropriate channels, including follow through to payment posting
• Conduct timely follow up to check for claims status
• Work closely with the Financial Navigation team to ensure accurate and timely processing of claims
• Claim denial review and understanding in how to evaluate for next steps
• Conduct outbound calls with manufacturer copay programs and foundation copay programs to resolve any issues or discrepancies
• Conduct outbound calls effectively with customer’s revenue cycle department to resolve any issues or discrepancies
• Post claim payments accurately and appropriately as received
• Maintain accurate records of all claims processed
• Meet productivity and quality standards

Qualifications

• 2+ years of experience in medical billing and coding, or financial navigation experience
• Ability to work effectively in a remote environment
• Experience working within EMRs and Billing Systems
• Experience working with insurance providers and healthcare organizations
• Knowledge of all insurance types
• Excellent communication and organizational skills
• Ability to work well in a fast-paced environment
• Willingness to adhere to and work during customer’s business hours
• High school diploma or equivalent required
• Workspace clear of noise and ability to work with PHI in a secure setting

Benefits

• Competitive salary + equity
• Premium medical, dental, and vision insurance plans, a wide range of voluntary and supplemental benefits, and 24/7 benefits access and support
• 401(k) plan
• Paid holidays, vacation, and sick leave
• Six weeks of paid parental leave
• Company-paid life insurance
• Company provided equipment and technology you’ll need to be successful in your role
• The opportunity to help shape the future of healthcare