What are the responsibilities and job description for the Employer Service Support position at The Health Plan (THP)?
The ESS is responsible for managing document queues to complete member reimbursement requests, provider pricing verification requests, network pricing appeals, and member balance bills. The ESS will also prepare pricing appeal response letters and other written correspondence sent via email or postal service including certified mail when needed. The ESS is responsible for timely completion of requests from the operations team.
Required
The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
8:00am-4:30pm
40
Required
- High School graduate or equivalent.
- Detail oriented and good critical thinking skills.
- Superb organizational skills.
- Able to communicate clearly and accurately with members, coworkers and management.
- Ability to prioritize and meet deadlines.
- Work efficiently in a fast-paced environment.
- Proficient in computer skills including Microsoft Office programs (Word, Excel, Office).
- Previous administrative experience.
- Knowledge in medical terminology and CPT and ICD-9/ICD-10 coding.
- Knowledge in health insurance.
- Answers all calls and correspondence in a timely, professional and friendly manner.
- Documents and tracks all information clearly and accurately.
- Completes work within deadlines.
- Communicates with members and providers as necessary to obtain information.
- Manages multiple tasks and priorities.
- Understands members benefits and plan to relay the information clearly and accurately.
- Understands claim detail, identifies claim issues and reports issues to management when necessary.
- Keep all member protected health information (PHI) confidential.
- Supports Manager and Employer Service Reps when needed.
The Health Plan is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. The Health Plan strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. The Health Plan employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.
8:00am-4:30pm
40