Customer Operations – Workers Compensation Claims

Job Description:

  • Make high-volume outbound calls to investigate, bill, and maximize payments on medical claims
  • Investigate and resolve troubled and/or denied workers' compensation claims
  • Contact patient employers, insurance company representatives, attorneys, and patients
  • Submit bills and proper documentation to insurance companies or appropriate payers
  • Ensure maximized payments to hospital and medical-provider clients
  • Review payer information and documentation when bills are not paid correctly
  • Determine next steps for incorrectly paid or unpaid bills
  • Participate in special projects to achieve team goals and ensure client success
  • Attend and actively participate in 8-10 business days of on-camera training

Requirements:

  • Must reside in the United States within one of the listed eligible states
  • Employment eligibility to work in the United States
  • Successful completion of a background check
  • Working knowledge of Microsoft Office (Word, Excel, Outlook)
  • Technical proficiency with multiple computer screens and software applications simultaneously
  • Ability to maintain strong performance in a fast-paced environment with productivity metrics
  • Ability to remain organized while multitasking
  • Critical thinking and problem-solving skills
  • Clear and professional verbal and written communication
  • Full focus during scheduled work hours with productivity tracking
  • Active participation on camera
  • Ability to manage a high volume of inbound and outbound calls while maintaining accuracy and productivity standards
  • Private, distraction-free home work environment
  • Secure internet connection
  • Home internet speeds greater than 20 Mbps download and 10 Mbps upload
  • Workspace accommodating workstation equipment and related materials
  • Experience with Coordination of Benefits and general understanding of insurance billing are a plus, but not required

Benefits:

  • Incentive Plan
  • Comprehensive training beginning on the first day and lasting 8-10 business days
  • Ongoing support from teammates following training
  • Robust knowledgebase for continued reference
  • Individual performance metrics for goal setting
  • Computers and necessary work equipment provided
  • Involved management support
  • Remote work from home
  • Secure internet and home office requirements supported by provided equipment
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