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Patient Advocate job in Atlanta at MultiPlan

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Patient Advocate at MultiPlan

Patient Advocate

MultiPlan Work From Home, GA Full-Time

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company.  We strive to create a workplace that fosters mutual respect and collaboration, where every talented individual can participate and perform their best work.  We are MultiPlan and we are where bright people come to shine!

JOB SUMMARY:
This role is responsible for handling member, client and provider inquiries (balance bills and appeals) based upon an assigned client base. This person is responsible for addressing member calls related to balance billing situations, educating of the process and negotiations for closing out the balance bills.
JOB ROLES AND RESPONSIBILITIES:
1. Manages facility, provider and member inquiries, appeals and balance billing; including correspondence.
2. Reviews and resolves balance bills and appeals with providers; through negotiations.
3. Identifies troubled facilities for potential direct contracting and redirection.
4. Ensures clear documentation of events associated to a claim resolution.
5. Provides updates and solicits required information from clients as needed.
6. Keeps direct report informed of critical matters that impact responding timely to appeals/balance bills.
7. Manages a daily running inventory of claims, prioritizing one's work schedule accordingly.
8. Addresses emails and incoming calls.
9. Ensures member inquiries are addressed timely; including education.
10. Participates in on-going process improvement to develop efficiencies that streamline the process and the Patient Advocacy Center.
11. Collaborates, coordinates, and communicates across disciplines and departments.
12. Ensures compliance with HIPAA regulations and requirements.
13. Demonstrates Company's Core Competencies and values held within.
14. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
15. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
This position works independently under minimal supervision to complete the assigned job responsibilities. Work performed is often varied and complex requiring a reliance on a knowledge base built through experience. The incumbent follows established procedures and uses knowledge of the company's general business principles, industry dynamics, market trends, and specific operation details when performing the duties of the position as assigned.

JOB REQUIREMENTS (Education, Experience, and Training):
* Minimum high school diploma. Baccalaureate degree (BA/BS) from an accredited college or university preferred
* Two (2) plus years experience in a medical healthcare claims role dealing with facilities, providers and members is required
* Background in healthcare claims management environment including provider hospital billing, claims adjudication and administration or the ability to interpret benefit plans/Explanation of Benefits
* Negotiation experience a plus
* A proactive, self-starter
* A high level of professionalism, organization and flexibility
* Strong organizational skills, demonstrating strong attention to detail
* Strong communication skills, both oral and written
* Excellent organizational skills demonstrating strong attention to detail
* Ability to manage high call volume
* Ability to multi-task effectively
* Detail focused
* Self-Motivating personality and a professional demeanor that promotes a team environment.
* Manages self and time so as to meet provided timeframes and deadlines, becoming flexible when necessary
* Able to work comfortably in a fast-paced environment
* Solid problem solving skills with the ability to determine and take the appropriate course of action for resolution
* Should possess a moderate to high level of claim editing, coding, RVU and CMS-based pricing knowledge with an emphasis in researching solutions for the above items as needed
* Bilingual preferred
* PC literate, including Microsoft Office products and web-based applications
* Required licensures, professional certifications, and/or Board certifications as applicable
* Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
* Regular, timely attendance

BENEFITS

 

We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.

Your benefits will include:

  • Medical, dental, and vision coverage (low copay & deductible)
  • Life insurance
  • Short- and long-term disability
  • 401(k) + match
  • Generous Paid Time Off
  • Paid company holidays
  • Tuition reimbursement
  • Flexible Spending Account
  • Employee Assistance Program
  • Summer Hours

 

[FOR POSITIONS THAT CAN WORK FROM HOME]

**Pursuant to Colorado’s “Equal Pay for Equal Work Act”, the following salary range is provided solely for applicants living in Colorado.  ($50-55K).  If an applicant does not live in Colorado, this salary range may not apply.  Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity.  This position is also eligible for health insurance, 401k and bonus opportunity.

 

EEO STATEMENT

MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you’d like more information on your EEO rights under the law, please [ Link removed ] - Click here to apply to Patient Advocate.

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