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Summary
This position requires primary focus on provider office phone calls or calls from their representatives. The position is responsible for maintaining provider/caller relationships by responding to phone inquiries and taking the appropriate actions for a 95% daily call resolution. This position requires primary focus on provider office phone calls or calls from their representatives by performing the following duties.
PLEASE NOTE: this is a telecommute/remote eligible position - however, due to our pay practices, qualified candidates MUST reside within one of the following states: OR, WA, CA, NV, AK, ID, MT, CO, UT, NM, TX, KS, IN, TN, SC, VA, and NY. While candidates need to live or relocate to one of the aforementioned states, working remotely will require reliable broadband internet and personal cell phone service. Telecommute/remote work may include working day-to-day operations during AllCare Health’s standard business hours (Pacific Standard Time) or online training.
Essential Duties
1. Documents the call in the incident module of the core claims system, reprocessing the claim if appropriate and providing excellent customer service.
2. 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.
3. Accurately records every provider/caller inquiry by documenting inquiry and response in customer’ service module and claim notes as applicable.
4. Accurately and efficiently adjudicate all professional claims applying benefits and pricing according to company policy, contract language and state Medicaid/Medicare guidelines.
Education & Experience
- Associate's degree (AA) or equivalent from a two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
- Ez-Cap experience (preferred).
Certificates, Licenses, and/or Registrations
- A Professional Coder Certification is required or to be obtained within 12 months of hire date.
Company Overview
AllCare offers competitive wages, an excellent benefit package that includes a 401k retirement, wellness program, and telecommute and flexible work schedule programs.
Since 2016, AllCare Health has been a Certified B Corp®. As a Certified B Corp®, AllCare Health considers its impact on society and the environment during the business decision-making process, and has long recognized the real value in social, economic, and environmental concerns of its stakeholders, including its employees, customers, and community members.
Grants Pass is located in Southern Oregon on the Rogue River and is surrounded by mountains and breathtaking views. The community is ideal for families and outdoor enthusiasts, with a temperate climate and easy access to outdoor recreation, wineries, outdoor concerts, the Ashland Shakespeare Festival, and much more.
AllCare Health: https://www.allcarehealth.com/
B Lab: https://bcorporation.net/about-b-corps
COVID-19 considerations
AllCare Health is following all safety guidelines and directives from OSHA, the CDC, OHA, and our local public health department.
Job Type: Full-time
Pay: From $18.50 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
Work setting:
- Hybrid remote
- Office
Education:
- Associate (Preferred)
Experience:
- coding: 1 year (Preferred)
- customer service: 1 year (Preferred)
- Microsoft office: 1 year (Preferred)
- EZ-Cap: 1 year (Preferred)
License/Certification:
- Professional Coder Certification (Preferred)
Work Location: Remote
