Claims Operations Associate (Contract) New Job at Reliance Health, Remote

cDhhWG9KTXFrK0JrRDF4Ukg2UXVwQkdSTGc9PQ==
  • Reliance Health
  • Remote

Job Description

The Claims Operations Associate is responsible for managing claims and approvals processes, and the scope of work includes vetting health insurance claims and approval from service providers, reconciling payments and negotiating and uploading claim tariffs.

Key Responsibilities

  • Examine and approve or reject healthcare providers’ claims to meet set targets.  

  • Investigate claims for fraud, waste, and abuse.  

  • Promptly resolve escalated approval requests for care.  

  • Negotiate tariffs and update the providers’ dashboard and execute other elements of tariff management.  

  • Collaborate with the technology team to improve the processes claims, tariff and approvals management system.  

  • Collaborate with customer success and provider relations teams to ensure customer satisfaction goals.

Requirements

  • Minimum of a first degree in medicine, nursing or pharmacy and completion of internship or houseman ship.  

  • Previous experience in a claim examiner role is a major advantage.  

  • Excellent numeracy, analytical and problem-solving skills.  

  • A high-level of responsiveness is essential and openness to working shifts including occasional weekends.  

  • Strong medical and clinical knowledge and experience.  

  • Excellent interpersonal and communication skills. 

  • Renumeration: 250k - 300k

Benefits

  • Join a market leader within the Insurance space

  • Unlimited leave days

  • Fantastic work culture

  • Work and learn from some of the best in the industry

  • Great work-life balance

Job Tags

Remote job, Contract work, Internship,

Similar Jobs

IP Casino Resort Spa

Facilites Lead Technician Maintenance - Plumber Job at IP Casino Resort Spa

Company Description Boyd Gaming Corporation has been successful in gaming jurisdiction in which we operate in the United States and is one of the premier casino entertainment companies in the United States. Never content to rest upon our successes, we will continue ...

Medasource

Patient Scheduling Specialist Job at Medasource

 ...Position: Medical Support Assistant Location: 100% onsite, possibility of remote work Duration: 1 year contract (strong possibility of extension!) Onsite : Denver, CO Full Time: M-F, Day Shift Overview: We are seeking reliable and mission-driven Medical... 

Resident360

Corporate Marketing Manager Job at Resident360

 ...align to company goals, prioritize ruthlessly, and report whats working (and whats not). ~ Campaigns that convert: Plan and run...  ...intelligence: Drive research on trends, competitor moves, target segments, and new opportunities; turn insights into action.... 

T&R Properties

Construction Superintendent Job at T&R Properties

 ...The Construction Superintendent coordinates all site construction activities and supervises all field personnel as required to successfully...  ...and field personnel, while administering good construction safety practices with all on-site activities. Maintains the job site... 

Judge Direct Placement

Plant Manager - Slaughter Environment Job at Judge Direct Placement

 ...grit to manage a demanding, "boots-on-the-ground" environment. Key Responsibilities Production Leadership: Oversee the daily harvest and primary processing operations. Ensure the facility meets production targets while maintaining high product quality and yield....