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Medical Claims Processing Specialist Job in Seattle, Washington

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Job Title: Medical Claims Processing Specialist

Required Certifications:CPC or CPB
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location: Seattle 98104, WA, US
Date Posted:2/26/2019

Job Summary

Are you an enthusiastic, highly motivated, empathetic, get-stuff-done kind of person? Do you love helping others? Are you a problem solver with grit who doesn't get frustrated easily?

If this sounds anything like you, please keep reading!

Decent is looking for a Medical Claims Processing Specialist with a flair for Customer Service.  We are a small company and our employees need to wear many hats. The primary responsibility will be claims processing, but this person will also be responsible for covering customer service hours.  

In your typical Decent day, you'll lead claims processing and help influence and develop our claim adjudication systems to be efficient and accurate. In addition, you'll be asked to supplement our customer care team by providing surprisingly delightful customer carewhile working alongside and learning from some of the best talents from the tech and health insurance industries. Flexible schedule and close partnership with a supportive team will make you feel right at home.

What You Will Be Doing

* Assist with building claim adjudication protocol and processes

* Develop claim adjudication training and onboarding materials for planned team growth

* Review and process healthcare claims

* Support providers with submitting a claim

* Support providers with understanding how and why a claim was processed and paid

* Provide chat, email, and phone support to shoppers, members, and providers

* Log member and provider interactions in CRM database

* Escalate customer issues to internal team for resolution when appropriate

* * Assist shoppers with general questions about Decent's health insurance plan

* * Assist members with typical inbound account questions (coverage confirmation, benefits questions, obtaining a new card, password reset, etc)

* Assist members with selecting a specialty provider, outpatient facility, etc

* Support providers with identifying and evaluating referral options

Additional responsibilities

* Ensure confidentiality in all work related functionality in accordance with HIPAA guidelines

* Identify trends and offer feedback to improve process and tools to drive satisfaction and engagement

What We're Looking For

* Certified Professional Coder (CPC) or extensive experience with claims processing, payment posting, etc. required

* Experience with Helpdesk and/or customer service tools (i.e. Salesforce, Zendesk, Drift)

* Understanding of health care customer service, regulatory requirements and proper dispute and/or member appeal process

* General understanding of Google Suite and Microsoft Office

* Proactive interest in technology and inclination to want to research and learn new technology

* High School graduate or equivalent

* Drive for building and making things better

* Comfortable speaking to all levels within an organization

* Be a team player. All team members must  be open to providing assistance when and where needed

* Confidence to call things out that don't make sense and propose a better way

* Ability to identify opportunities for improving process and tools

* Ability to take initiative and ownership of assigned tasks, working independently with minimal supervision, yet maintain a team-oriented and collaborative approach to problem solving

* Friendly, patient, and professional phone demeanor

* Helpful personality with a strong sense of empathy and positivity

* Excellent verbal and written communication skills

* Loads of attention to detail

What Will Make You Stand Out

* Spanish speaker

* Ability to take a complex subject and simplify it with ease

Compensation includes an hourly range of $20-$30 (dependent upon certifications), medical and dental benefits, casual office environment, career advancement opportunities in a small but quickly growing company, and generous PTO.

Check us out at www.decent.com


Please submit a resume and cover letter to brooke@decent.com

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