Job description
Your Future Evolves Here
New Century Health (NCH) has been transforming the delivery of specialty care and driving radical cost and quality improvement across the member journey for patients with cancer and cardiovascular disease. As part of Evolent Health, we are on a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.
Why We’re Worth the Application:
- We continue to grow year over year.
- Recognized as a leader in driving important
diversity, equity, and inclusion (DE&I) efforts.
- Achieved a 100% score two years in a row on the
Human Rights Campaign's Corporate Equality Indexrecognizing us as a best place to work for LGBTQ+ equality.
- Named to Parity.org’s list of the best companies for women to advance for
3 years in a row(2020, 2021 and 2022).
- Continue to prioritize the employee experience and achieved a 90% overall engagement score on our employee survey in May 2022.
- Publish an annual
DE&I reportto share our progress on how we’re building an equitable workplace.
What You’ll Be Doing:
Under the direction of the Senior Manager, Reimbursements, the Carrier Services Coordinator is responsible for reviewing all outstanding accounts on a regular basis, contacts insurance carrier and/or responsible party to identify reasons for non-payment, identifies and institutes the appropriate solutions to resolve the account. This may include rebilling the claim, sending letters or additional information and appealing responses from third party payers. This position adds the greatest value to the organization when they identify patterns in reasons for nonpayment and work directly with appropriate personnel to implement solutions that reduce or eliminate process errors. These activities are to be performed in compliance with federal, state and local laws in addition to facility and corporate policy. This individual at all times projects a professional appearance and customer friendly demeanor while maintaining the confidentiality of patient, coworker and facility information. This position at times works under stress and in situations that demand patience and tact while providing impeccable service.
Essential Duties and Responsibilities:
- Follow-up with health plans and other team members to verify quick and accurate workflow for minimum DSO
- Prepare accurate and complete claims/statements and submits claims/statements in a timely manner to meet claims processing requirements
- Understands all contracts and billing requirements and reviews pricing with claims to ensure accuracy
- Ensures completion or receipt of all documents needed for billing and all other documents, as appropriate
- Check all billing, line by line, to make sure that the claim is billed to the proper payer source, in the proper billing format, with the appropriate codes and quantities
- Submit the necessary admission notice to payers/providers on a daily basis
- Maintain billing files on all assigned patients and generates billing satments to payers and customers in a timely manner
- Research and resubmit cliams without response or denied in established time frame
- Resolves billing payments problems in detailed organized fashion focusing on the company's standard for DSO
- Performs follow-up by proper utilization of computer generated reports
- Documents contacts with outside individuals on billing issues
- Informs Manager of problem accounts promptly
- Strict adherence to all company policies and procedures
- Works with management to obtain corporate financial goals and objectives
- Performs schedules hours, staggered shifts in accordance to the needs of the company
- Handles patients, family and healthcare professional calls that may involve resolving conflicts and/or the completion of information professionally
- Supports calls from patients or customer regarding outstanding balances
- Post carrier payments, denials and claims rejections via computer
- Identify and process credits and write-offs with Manager's approval
- May perform other duties not specifically listed in the position description as assigned by supervisor
Education and/or Experience we Prefer:
- 2+ years in healthcare collections
- Requires previous health plan experience
- College degree, preferred
Technical Requirements:
Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 Mbps, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and national law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home.
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.
Compensation Range: The minimum salary for this position is $20/hr, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.
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