Independent Dispute Resolution Rep

Posted 2 Days Ago
Be an Early Applicant
McFarland, CA
Junior
Healthtech • Insurance
The Role
The Independent Dispute Resolution Representative is responsible for processing and coordinating all materials related to independent disputes and negotiations in accordance with federal and state regulations. This includes intake, database entry of new requests, and effective communication with providers based on thorough knowledge of guidelines.
Summary Generated by Built In

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This Position Is Responsible For Intake, Processing, Coordinating All Materials And Information Relating To Processing Negotiations And Independent Disputes As Regulated By Federal Or State Regulations.. This Applies To All Plans At Hcsc, All Lines Of Business And All Products.. Additionally, This Position Will Accurately Process And Respond According To The Hcsc Procedures Via The Required Notifications And Provider Resolution.. This Includes Entry Of New Requests Via The Appropriate Database.

JOB REQUIREMENTS:
• High School Degree or GED.
• Analytical, problem solving and research skills.
• Organizational skills to accommodate large volume of reference materials combined with time management skills.
• Verbal and written communication skills to clearly express oneself; exercises diplomacy.
• Experience working both independently and in a team environment to meet deadlines according to regulations
• 1 year experience in a customer service role OR in a health insurance or medical environment.
• Experience and skills to analyze and assist the provider based on knowledge of federal, state guidelines.
• Experience and skills to organize tasks and accommodate large volume of reference materials.
PREFERRED JOB REQUIREMENTS:
• BlueChip claims payment experience.
• Medical terminology.
• Ability to think clearly and maintain a professional, poised attitude under pressure.
• Detail oriented.
• 2-year experience processing claims and utilizing a claims payment system.

#INDM


Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!


HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$17.20 - $27.15

The Company
HQ: Chicago, IL
13,563 Employees
On-site Workplace

What We Do

Imagine Something New, Something Different.

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is the largest customer-owned health insurer in the nation and the fourth largest overall. Operating through our Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas (as well as a variety of affiliates and subsidiaries,) we are expanding access to high-quality, cost-effective health care. We are equipping members with information and tools so they can make the best health care decisions for themselves and their families.

HCSC is continuously recognized as an employer committed to community, diversity and inclusion, training and development.

HCSC is committed to pioneering the health care space in ways as effective as they are creative. If you are passionate about the impact you want to have through your work, with a desire to apply innovative thinking to new and emerging challenges, we encourage you to learn more about HCSC.

Learn about what we stand for, how we work and the difference we’re making in the lives of our 15 million members. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization.



Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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