ClaritevCL

Sr. Customer Service Specialist (Remote Inbound Call Center)

MultiPlan, now operating as Claritev, is a leading U.S. healthcare technology company that provides data analytics and technology-enabled solutions to manage the cost of care and improve competitiveness for healthcare payors.

Claritev

Employee count: 1001-5000

Salary: 40k-40k USD

United States only

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

Come show off your customer service soft skills as a Sr. Customer Service. This position is responsible for the handling, research, and communication regarding complex and escalated claims inquiries stemming from patients, clients, provide. Ideal candidates will have three years of call center customer service experience with knowledge of healthcare claims and appeals procedure. Experience in remote working and knowledge of insurance company and medical service provider terminology highly desirable.

• You will have a steady Monday through Friday 40 hour per week schedule between the hours of 8:00 am and 5:00 pm CT. Employees are able to pick from available flexible schedules after completing training.
• Earn $19.18 per hour (pay varies based on incumbents state of residence) and have the opportunity to receive additional quarterly bonuses based on performance after completion of 90 work day probationary period.
• We provide an excellent paid virtual classroom training program as well as continuous on the job coaching and mentoring. We also have advancement and growth opportunities available to employees.
• Find more information on what it’s like to be a MultiPlan employee on our Careers page at www.multiplan.com

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JOB SUMMARY: This position is responsible for the handling, research, and communication regarding complex and escalated claims inquiries stemming from patients, clients, providers, and internal customers', including both intake and resolution. In addition, this position is also responsible for coaching and mentoring.

JOB ROLES AND RESPONSIBILITIES:

1. Investigate, analyze, research, and resolve complex and escalated claim inquiries from patients, clients, providers, and internal customers' as a result of issues related to discounts, payments and balance billing. This includes handling legal inquiries or department of insurance complaints.
2. Provide resolution and closure to the applicable recipients. Create and execute business correspondence to clients or providers using multiple media formats such as but not limited to emails, form letters, and issues specific letters. This includes initiating resolution and follow up calls to clients and providers.
3. Adhere to client turn around requirements as it relates to response time and required actions.
4. Ensure investigative notes related to any contact with providers and clients are documented and accessible throughout the applicable systems.
5. Ensure the maintenance of and compliance with department standards for production, accuracy, and turnaround time.
6. Perform system claim adjustments based on outcomes and communicate with client regarding confirmation.
7. Assume and resolve escalated claim and inquiries from team members. Serves as back-up for team members, or Leadership.
8. Coach and mentor less experienced team members on claims handling, resource utilization, and appropriate resolutions.
9. May include call center responsibilities, including adhering to call center standards.
10. Assist in training new team members as needed and providing feedback to Leadership.
11. Various research projects for Sr. Management and Clients, as assigned.
12. Collaborate, coordinate, and communicate across disciplines and departments.
13. Ensure compliance with HIPAA regulations and requirements.
14. Demonstrate Company's Core Competencies and values held within.
15. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
16. 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:

The incumbent works under minimal supervision to complete job responsibilities in applying a fundamental knowledge of principles, practices and procedures related to the servicing of inquiries and providing resolution and follow-up, where necessary. Work is complex and requires independent judgment within established guidelines; however, may seek guidance from management as needed. This job has regular contact with external and internal customers. Individual may act as a primary contact for priority clients. While this is not a supervisory job, an incumbent acts as a resource to the Team and may provide input to management on training recommendations.

Qualifications

JOB REQUIREMENTS (Education, Experience, and Training):
* Minimum completion of high school (i.e., diploma or GED)
* Minimum 3 years experience in the healthcare industry or customer service, preferably with out-of-network claims.
* Required licensures, professional certifications, and/or Board certifications as applicable.
* Bilingual English/Spanish may be required of some positions.
* Knowledge of health care claims and appeal procedures .
* Knowledge of insurance company and medical service provider vocabulary desirable
* Communication (written, verbal and listening) problem solving, interpersonal and decision-making skills.
* Ability to create and compose business correspondence
* Ability to multitask while setting priorities
* Ability to analyze data and arrive at a logical conclusion
* Ability to identify issues and determine appropriate course of action for resolution
* Ability to elicit trust and credibility with all levels of the organization
* Ability to work with accuracy in a fast-paced environment
* Ability to adjust/alter workflow to meet deadlines
* Ability to work independently as well as part of a team
* Ability to handle confidential information.
* Ability to handle high pressure situations and variance in workload volume
* Ability to use software, hardware and peripherals related to job responsibilities including MS Office
* 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

COMPENSATION

The salary range for this position is$19.80. 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.

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 with low deductible & copay
  • Life insurance
  • Short and long-term disability
  • Paid Parental Leave
  • 401(k) + match
  • Employee Stock Purchase Plan
  • Generous Paid Time Off -- accrued based on years of service
  • WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
  • 10 paid company holidays
  • Tuition reimbursement
  • Flexible Spending Account
  • Employee Assistance Program
  • Sick time benefits -- for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits

APPLICATION DEADLINE

We will generally accept applications for at least __15_ calendar days from the posting date or as long as the job remains posted.

Claritev 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 would like more information on your EEO rights under the law, please click here.

About the job

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Posted on

Job type

Full Time

Experience level

Senior

Salary

Salary: 40k-40k USD

Location requirements

Hiring timezones

United States +/- 0 hours

About Claritev

Learn more about Claritev and their company culture.

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Through groundbreaking technology and data-driven insights, we are revolutionizing healthcare affordability and transparency at MultiPlan, now operating as Claritev. For over four decades, our company has been at the forefront of the U.S. healthcare industry, pioneering solutions that address the complex challenges of medical cost management. Our innovative approach leverages sophisticated data analytics and a team rich with industry experience to interpret our clients' needs and customize solutions that combine payment and revenue integrity, network-based services, and analytics-based strategies. We are committed to bending the cost curve in healthcare, making it more transparent, fair, and affordable for everyone. Our services are designed to identify significant savings in medical costs, lower out-of-pocket expenses for consumers, and reduce or eliminate balance billing, thereby fostering a more sustainable healthcare ecosystem.

Our technological evolution is central to our mission. We have made substantial investments in our data infrastructure and technology, including a significant partnership with Oracle Cloud Infrastructure, to enhance our capabilities. This allows us to harness the power of our extensive data assets, accumulated over 40 years, to build new and innovative solutions. By employing advanced data science, machine learning, and artificial intelligence, we deliver actionable insights that optimize benefit plan design, improve payment accuracy, and drive more meaningful decision-making for our partners. We serve a broad spectrum of the healthcare market, including over 700 healthcare payors, more than 100,000 employers, 60 million consumers, and a network of 1.4 million contracted providers. Our recent rebranding to Claritev reflects our transformation and commitment to bringing clarity and technological advancement to a wider segment of the healthcare ecosystem, ensuring that we are not just a service provider but a pivotal health-tech innovator shaping the future of healthcare.

Employee benefits

Learn about the employee benefits and perks provided at Claritev.

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Paid company holidays

10 paid company holidays.

Paid Parental Leave

Paid leave for new parents.

Life Insurance

Company-paid life insurance.

Commuter benefits

Discount programs for transit.

View Claritev's employee benefits
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Claritev hiring Sr. Customer Service Specialist (Remote Inbound Call Center) • Remote (Work from Home) | Himalayas