Independent Dispute Resolution Representative
Job Purpose:
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:
* Experience reviewing/investigating claims
* Knowledge of Texas SB 1264
Location:
Can be in office or telecommuter.
*CA
#LI
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements:
Expertise Claims & Customer Service
Job Type Full-Time Regular
Location OK - Tulsa, TX - Richardson, TX - San Angelo, TX - Abilene, TELECOMMUTE, TX - Wichita Falls, IL - Jacksonville, TX - Austin, IL - Chicago, IL - Quincy, TX - Marshall, NM - Albuquerque, IL - Mattoon
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.
If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.
Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".