The impact you will make
We are looking for a dynamic Healthcare Operations Representative to assist our clients in completing payer enrollments in order to successfully submit and receive electronic EDI transactions. You will be expected to effectively communicate with the appropriate stakeholders throughout the enrollment process cycle. As a Healthcare Operations Representative, you will be responsible for managing customer support queues to ensure items are acknowledged and routed to the appropriate teams quickly and efficiently. You will also be responsible for researching and resolving inquiries from clients related to user access requests, assisting with invoicing inquiries and appropriately responding to general questions of low to moderate complexity. At the direction of management, you may take the lead on projects of various size and scope within your area of responsibility and control.
What You Will Do
- Monitor and manage work queues to ensure inquiries are routed to the appropriate team members with speed and accuracy.
- Respond timely to queries from clients and insurance companies through email and telephone as appropriate.
- Troubleshoot and provide analysis, support and guidance on all issues related to payer enrollments, user access requests, invoices and other general questions.
- Assist portal clients with user account management and permission requests.
- Work with clients, payers and intermediaries to ensure proper enrollment for electronic healthcare responses and facilitate resolution of payer enrollment denials.
- Maintain and document enrollment processes and procedures, including payer/intermediary application processing timelines and requirements.
- Proactively identify potential enrollment issues based on provider type or payer type.
- Develop and maintain both internal and client-facing documentation.
- Communicate issues to management regarding payer, system or escalated account issues.
- Assist Operations Support Analysts in resolving various routine requests from clients.
- Participate and attend meetings and in-house trainings to develop and expand job knowledge.
- Client requested meetings
- Phone support
- Perform all other related duties as assigned.
What You Will Bring
- Graduation Degree or equivalent
- 0-3 years of related work experience in the healthcare industry or customer service industry preferred.
- Ability to read, analyze, and interpret professional journals, technical procedures, and governmental regulations
- Strong written / verbal communication, interpersonal, and relationship skills
- Ability to work in a team environment that requires quick turnaround and quality output
- Knowledge of HIPAA, EDI and Healthcare X12 transactions is a plus.
- Must be proficient with personal computers and related software applications such as Microsoft Office Suite
- Ability to adapt quickly to new technologies, processes and changing priorities
- Understanding of and experience in supporting continuous integration/continuous deployment
- Collaboration skills to gather input and then experiment with available solutions to validate assumptions and feasibility.
- A team-oriented mind set
- An enthusiastic, can-do attitude, problem solving skills and a relentless improvement mindset.
- Excellent organizational and time management skills
- Travel required: None.
What We Would Like To See
- Excellent verbal and written communication skills, with the ability to present information within a public setting.
- Experience in the healthcare industry.
- Customer service experience preferred.
- Salesforce.com experience is a plus.
- Knowledge of claims rejections/denials experience a plus
About FinThrive
FinThrive is advancing the healthcare economy.
For the most recent information on FinThrive’s vision for healthcare revenue management visit finthrive.com/why-finthrive
Award-winning Culture of Customer-centricity and Reliability
At FinThrive we’re proud of our agile and committed culture, which makes FinThrive an exceptional place to work. Explore our latest workplace recognitions at https://finthrive.com/careers#culture
Our Perks And Benefits
FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits.
- Professional development opportunities
- Term life, Accidental & Medical Insurance
- Meal and Transport arrangements
FinThrive’s Core Values and Expectations
- Demonstrate integrity and ethics in day-to-day tasks and decision-making, adhere to FinThrive’s core values of being Customer-Centric, Agile, Reliable, and Engaged, operate effectively in the FinThrive environment and the environment of the workgroup, maintain a focus on self-development and seek out continuous feedback and learning opportunities
- Support FinThrive’s Compliance Program by adhering to policies and procedures about HIPAA, GLBA, FCRA, and other laws applicable to FinThrive’s business practices; this includes becoming familiar with FinThrive’s Code of Ethics, attending training as required, notifying management or FinThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.
FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.
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