Claims Call Center Analyst I

We Are Seeking Qualified Candidates to Join Our Team!

AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

Summary of the Position

This position serves as a primary point of contact for provider offices, managing high volumes of incoming phone calls and email inquiries with professionalism and accuracy. The role focuses on building and maintaining positive provider relationships by delivering timely resolutions, aiming for a 95% same-day call resolution rate. In addition to frontline support, the position includes claims processing responsibilities during designated rotation periods by performing the following duties:

Essential Duties

1. Provider Communication & Support – Respond promptly to inbound calls and provider portal emails from provider offices or their authorized representatives, ensuring inquiries are addressed with professionalism and accuracy.
2. Documentation & Resolution – Accurately document all calls in the incident module of the core claims system (or other approved software). Reprocess claims when appropriate and ensure provider concerns are resolved effectively.
3. Inquiry Management – Understand and address provider inquiries by reviewing prior case history, gathering and researching relevant data, and delivering accurate responses. Confirm provider understanding of the information shared.

Being bilingual in another language, including American Sign Language (ASL), is an invaluable skill that enhances our ability to deliver culturally responsive care. We strongly encourage you to apply if you are bilingual.

All relevant experience can be listed in your resume to perform essential duties of the position including the following: lived, volunteer, professional, or a combination of experience and education.

Education

• High school diploma or general education degree (GED).

Experience

• Six months to one-year experience and/or training in claims, call center or Healthcare related position.

Certificates, Licenses, and/or Registrations 

• An AAPC Certified Professional Coder certificate is required or to be obtained within 12 months of hire date.
  1. Cost of certification is company paid and is subject to pay increase upon completion.

Technical Skills

• Proficiency in Ez Cap, medical terminology, ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and familiarity with CMS-1500, UB-04, and other standard claim forms.
• Demonstrates advanced customer service skills, including service recovery and multi-line call center operations.
• Skilled in healthcare industry practices, HIPAA compliance, and trauma-informed care.
• Strong computer literacy, including Microsoft Office, with excellent writing, editing, and organizational abilities.
• Experienced in interpreting data, identifying process improvements, and synthesizing information from multiple sources.
• Knowledgeable in training best practices, adult learning principles, and the impact of identity, bias, and equity in organizational systems.

Interpersonal Skills

• Demonstrates accountability, empathy, and professionalism while working effectively in a fast-paced, multicultural environment. 
• Communicates clearly, resolves conflicts independently, and collaborates across diverse teams. 
• Adapts to change, manages stress, and prioritizes tasks to meet competing deadlines. 
• Applies sound judgment, cultural awareness, and inclusive practices to deliver respectful, high-quality service to all individuals.

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The noise level in the work environment is usually moderate.

• The employee must be able to work onsite as needed.
• The employee must be able to work from a home office as needed.

Company Overview

AllCare Health Website:  https://www.allcarehealth.com.

AllCare Health is incorporated as an Oregon Benefit Corporation and has earned the coveted Certified B Corp® status since 2017. As such, AllCare Health considers its impact on community, society, and the environment in all business decisions. We have long recognized the value in social, economic, and environmental concerns of our employees, customers, and community members. (Learn more about B Corps at https://bcorporation.net/about-b-corps)

AllCare Health headquarters are located in Grants Pass in Southern Oregon on the Rogue River, surrounded by mountains, forests, small farms, and breathtaking views. This thriving and energetic community is ideal for families and outdoor enthusiasts, with a temperate Pacific Northwest climate. We enjoy easy access to outdoor sports and recreation, river rafting, fishing, hiking, biking, wineries, outdoor concerts, the world-famous Ashland Shakespeare Festival, the stunning Oregon coast, magnificent redwood forests, pristine beaches, and much more.

The AllCare Health family of businesses is guided by our corporate principles:

Purpose | Working together with our communities to improve the health and well-being of everyone.

Values | Trust, Innovation, Relationships, and Voice.

Vision | Thriving, Inclusive, and Equitable communities.

Brand Promise | Changing Healthcare to Work for You.

AllCare Health is dedicated to building a diverse and authentic workplace centered in belonging and serving our growing community. If you are excited about this open position but your experience does not align perfectly with every qualification in this post, we encourage you to apply anyway or reach out to our human resources department. You may just be the right candidate for this role or others. 

If you need accommodations, help in the application process, or wish to receive this job announcement in an alternative format, please call 541-471-4106 and ask for Human Resources.

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.