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 talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
2. Identify and notify the supervisor of potential escalated issues or system related concerns.
3. Assist in training new employees and remedial training for existing employees, including new or revised procedures.
4. Provide general support to the team members, serve as a resource and answer questions Serves as subject matter expert and as back-up within the team.
5. Coach and mentor staff while assisting with more challenging issues and cases.
6. Support the quality audit review and rebuttal process.
7. Ensure the maintenance of and compliance with department performance metrics for production, accuracy, and turnaround time.
8. Foster and maintain relationships with internal and external customers, including but not limited to the provider, client, member, or other internal customer.
9. Monitor compliance with all departmental policies, procedures, and workflows and collaborate with the training team, as necessary.
10. Review workflows and outputs to recommend appropriate workflow revisions and collaborate with other internal departments.
11. Lead and/or participate in 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.
* Minimum 2 years of experience in the healthcare industry or customer service. Leadership experience preferred.
* State licensure certification, including NY Health and/or P&C State Adjustor license, may be required. If hired without certification, certification must be obtained, and maintained thereafter, within six months of notification. If the required state licensure certification(s) are not obtained or renewed within six months of notification, an employee may be moved to a position within a relevant job family that does not require certification/licensure, if and when such position is available. When an alternate position is unavailable, other employment actions may be implemented consistent with MultiPlan practice and policy.
* Knowledge of claims processing and procedures
* Knowledge of applicable laws and statutes (state, local or federal) for positions focusing on Workers' Compensation or automobile medical "auto" bills.
* Communication (written, verbal and listening), problem solving, organization, and time management skills.
* Strong verbal and written communication skills
* Ability to multitask and handle multiple projects simultaneously, prioritize and meet expected deadlines.
* Ability to lead and mentor others in a positive and respectful manner.
* Ability to identify issues and determine appropriate course of action for resolution.
* Ability to use software and hardware related to job responsibilities, including MS Office with preferred proficiency in MS Word and MS Excel spreadsheets and database software.
* Ability to adjust workflow and alter schedule to meet deadlines in a fast-paced environment.
* Ability to work independently and handle confidential information.
* 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.
Skills Required
- Minimum completion of high school (diploma or GED)
- Minimum 2 years of experience in healthcare or customer service
- State licensure certification may be required
- Knowledge of claims processing and procedures
- Strong communication and organizational skills
What We Do
Claritev is an independent and public healthcare technology, data and insights company making healthcare more transparent, fair and affordable for all. We work across the healthcare value chain to expose imbalanced and inefficient pricing practices. Led by deeply experienced analysts, negotiators and innovators, Claritev provides tech-enabled solutions and services fueled by proprietary data from over 40 years of experience. Today, along with machine learning and AI, we utilize a robust enterprise platform to deliver price transparency, improve payment accuracy, and drive more meaningful analytics and decision-making. Through Claritev, providers are able to make data-enabled decisions to optimize their service offerings, market position and ultimately deliver high-quality care. Payors and third-party administrators can deliver greater flexibility and value to plan sponsors. Employers can drive cost-efficient benefit design and patients can finally afford the care they need. By focusing on customized solutions that that improve transparency, affordability and quality for all key players, we’re igniting a more competitive marketplace — one that lowers overall costs while improving quality. Claritev brings the transparency our nation needs to see its way to a better healthcare system.
