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Description:This role is to provide support for day-to-day Business Office operations which covers 3 departments:
Benefit Verification
Claims Recovery (this is the bulk of the work / people) - will cover both and in and out of network claims
Billing teams. (very basic billing - credit card processing)
Supervise and provide daily support to teams to ensure excellent service to patients and providers. Make recommendations for improvement of current processes to further support growth and deliver compassionate care through patient/ health care professionals’ interactions. Partner directly with department leadership to drive continuous improvement efforts and ensure patient/health care plan satisfaction. Work closely with department managers to implement new procedures and create training material to ensure continuous development and support for the departments. Collaborate with department leadership on managerial tasks such as ongoing representative training. Mentor and develop representatives through effective support and training. Perform ongoing monitoring of teams. Coordinate with appropriate internal teams and well as health plan representatives to manage patient escalations. Answer incoming and outbound calls, effectively communicating the program details and provide ongoing support to patients in a clear and understandable manner. Participate in recruiting and onboarding new team members. Provides coaching and feedback to representatives to assist in professional growth. Ensure all compliance standards and performance guarantees are met or exceeded Ensure team is accurately and timely verifying member benefits with various payers, and that the team is accurately and timely processing & adjudicating both in and out of network claims Responsible for working directly with external and internal audit teams, participating in, and responding to audit requests claims adjudication accuracy Prepare accurate detailed reports for internal and external stakeholdersQualifications: 5+ years of operational claims management experience required A minimum of 2 years work experience in Medical Billing and full understanding of rev cycle processes and flow Min 2 years extensive knowledge in Prior Authorizations, Benefit Verifications, and or related health care tasks.Experience Level:Expert LevelAbout Aston Carter: Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com (%20astoncarteraccommodation@astoncarter.com) for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
