Overview
Reimbursement/Claims Specialist (100% Paid Health Benefits) Jobs in Orlando at The Assistance Fund
We’re a unique organization. We help patients who need financial assistance every day. We make a difference. We change lives. Our vision is to see the day when no person goes without medication due to an inability to pay. Until then, we exist so that patients don’t have to miss taking their medication because of cost. Every TAF team member plays an important role in helping our organization support our patients. We strive to do this in the most efficient, compliant and compassionate manner possible.
EOE Statement: We are an Equal Opportunity Employer.
Summary of Position: The Reimbursement/Claims Specialists are responsible for reviewing and reconciliation of claims for accuracy and ensures all corrections have been made before final submission for payment.
Responsibilities:
- Provide support by reviewing, researching, investigating, processing, and adjusting claims.
- Ensures Quality and Productivity standards are maintained.
- Review and process new claims.
- Resolves claims within 48 hours after they are received. Notifies leadership if this goal cannot be attained
- Liaising with insurance companies, patients, and service providers
- Comply with HIPAA patient privacy and security regulation standards and applicable patient authentication and data security standards
- Appropriately update Salesforce.com to reflect current statuses of program participants, including but not limited to all written or verbal communications, issues, and claims submissions.
- Provides backup as needed to phone and chat queues, and maintains working knowledge of a Patient Advocate 2.
- Support and contribute to a conducive work environment that encourages camaraderie, open communication, and understanding.
- Regularly provide feedback on the effectiveness and soundness of program policies and procedures.
- Perform special projects on an as needed basis.
Qualifications:
- Education level of at least a high school diploma or GED or equivalent years of work experience
- 1 year experience processing medical claims
- Professional level skills in computer use, including but not limited to Microsoft Office, email, web-based applications, and keyboard skills.
- Ability to adapt and learn quickly, specifically in accordance with organizational and program policies and procedures.
- Ability to work in customer care and provide professional level service.
- Demonstrate strong written and verbal communication skills.
- Interpersonal skills to facilitate work with a wide range of individuals and groups from culturally diverse publics.
- Proven ability to multitask and maintain organization in a working from home office.
- At home office are with no distractions
- Stable WiFi connection at least 100 mbps
Preferred Qualifications:
- Salesforce Experience
- 6 months or more of Claims Management Experience
- Bilingual Spanish/English is a plus
Physical Demands:
The work requires the incumbent to remain at a desk most of the time. Tight deadlines must be met with limited staff to support projects. Work Environment: The work environment is in an office setting that is adequately lighted, temperature controlled and ventilated.
Benefits: TAF offers a comprehensive employee benefits program, including:
401(k) retirement account – You will be eligible to participate in the TAF 401(k) plan after completion of your ninety (90) day probationary period. TAF provides a 100% match of employee contributions to the 401(k) plan up to 6%.
Health, dental, vision and life insurance – You will be eligible to participate in these TAF benefits on the first day of the month following completion of your thirty (30) day waiting period. TAF offers three health insurance plans to choose from. The first plan level are fully paid by TAF . Health insurance for employee plus spouse, child(ren) or family are provided in accordance with the summary of plan benefits. Likewise, dental, vision, life insurance and other benefits are provided in accordance with the summary of plan benefits.
Job Type: Full-time
Pay: From $18.00 per hour
Benefits:
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Parental leave
- Referral program
- Retirement plan
- Vision insurance
Application Question(s):
- Are you able to travel to Orlando, FL 32839 on scheduled days?
Experience:
- Customer Service: 2 years (Preferred)
- Processing medical claims: 1 year (Required)
Work Location: In person
Title: Reimbursement/Claims Specialist (100% Paid Health Benefits)
Company: The Assistance Fund
Location: Orlando
