Claims Call Center Analyst I position available at AllCare Health within the Claims department, located in Grants Pass, Oregon.
***Please note- This is NOT a fully remote position***
-
Employees are required to work from the Grants Pass, Oregon office for a minimum of two days each week.
-
Employees may opt to work from a home office for up to three days per week if they choose the hybrid work-from-home option.
-
Upon completion of the training period, the employee may have the option to work entirely remote, subject to the Hiring Manager's discretion.
We Are Seeking Qualified Candidates to Join Our Team!
AllCare Health provides competitive salaries, an outstanding benefits package that includes cost-effective healthcare, 401k retirement plans, wellness initiatives, and options for flexible scheduling.
Summary
The primary responsibility of this position is to handle phone calls from provider offices or their representatives. It involves sustaining provider/caller relationships through prompt responses to phone inquiries and ensuring appropriate measures are taken to achieve a 95% daily call resolution rate. The role entails diligently performing the following duties to maintain a focus on provider office phone calls or their representatives' calls.
Essential Duties
-
Documents the call in the incident module of the core claims system, reprocessing the claim if appropriate and providing excellent customer service.
-
Responds to provider/caller inquires by understanding inquiries; reviewing previous inquiries and responses; gathering information and researching information; assembling and forwarding information; verifying customer’s understanding of information and answers.
-
Accurately records every provider/caller inquiry by documenting inquiry and response in customer’ service module and claim notes as applicable.
-
Accurately and efficiently adjudicate all professional claims applying benefits and pricing according to company policy, contract language and state Medicaid/Medicare guidelines.
Education & Experience
-
An Associate's degree (AA) or its equivalent from a two-year college or technical school; alternatively, six months to one year of related experience and/or training; or an equivalent combination of education and experience.
-
Preference is given to candidates with at least one year of Ez-Cap experience.
Certificates, Licenses, and/or Registrations
-
A Professional Coder Certification is required or to be obtained within 12 months of hire date.
Physical Demands & Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate.
-
Employees are required to work from the Grants Pass, Oregon office for a minimum of two days each week.
-
Employees may opt to work from a home office for up to three days each week if they choose the hybrid work-from-home option.
Company Overview
AllCare Health Website: https://www.allcarehealth.com.
AllCare Health, incorporated as an Oregon Benefit Corporation, has held the prestigious Certified B Corp® status since 2017. In line with this, AllCare Health evaluates its impact on the community, society, and environment in every business decision. The company has consistently acknowledged the importance of addressing the social, economic, and environmental interests of its employees, customers, and the community.
The AllCare Health headquarters is nestled in Grants Pass, Southern Oregon, along the Rogue River, encircled by mountains, forests, small farms, and stunning vistas. This vibrant and dynamic community is perfect for families and those who love the outdoors, offering a mild Pacific Northwest climate. Residents relish the convenience of outdoor activities and recreation, including river rafting, fishing, hiking, cycling, vineyards, open-air concerts, the renowned Ashland Shakespeare Festival, the spectacular Oregon coast, majestic redwood forests, unspoiled beaches, and so much more.
The AllCare Health family of businesses is guided by our corporate principles:
Purpose | Working together with our communities to improve the health and well-being of everyone.
Values | Trust, Innovation, Relationships, and Voice.
Vision | Thriving, Inclusive, and Equitable communities.
Brand Promise | Changing Healthcare to Work for You.
AllCare Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.