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Customer Success Operations Analyst (Medical Billing & Coding)

Tampa, FL 33607 | Work from home flexibility

Posted: 01/30/2024 Employment Type: Direct Hire Job Category: Customer Service Job Number: 19467 Earning Potential: 60,000

Job Description

Job ID 19467 – Customer Success Operations Analyst 

Location:  Tampa, 33607 – WFH Flexible

Must report to the office approximately (2) days per month

Pay: $60,000 yearly

Type:  Direct hire


Schedule:  M-F, Flexible schedules between the hours of 8am-8pm EST

Summary:
Provide internal and external support.  Claims coding and editing investigation, communicate claims decisions to providers and health plan clients.  Place outbound calls and send emails to clients for status updates on claims issues to facilitate resolution. 

Job description:
  • Serve as the Operational Subject Matter Expert for client engagement.
  • Provide customer and provider education as needed.
  • Evaluate disputed claims for system configuration, claims processing, and contractual issues.
  • Track and monitor client and provider issues, scheduling meetings for resolution.
  • Communicate client needs effectively and advocate on their behalf.
  • Collect and escalate data related to claims from clients.
  • Run and execute client queries and internal reports.
  • Respond to provider and client ticket requests within established turnaround times.
  • Provide excellent customer service.
  • Understand business needs and processes, recommending resources for improvements.
  • Collaborate with other departments to support client needs.
  • Assist with special assignments and projects requiring extensive research.
  • Perform outbound calls to investigate aging reconsideration submissions and claims payment details.
  • Deliver timely analysis of claims in response to providers.
  • Store and maintain multiple electronic documents.
  • Perform other assigned duties to facilitate issue resolution for health plan clients.

Nice to have:
  • Bachelor’s Degree
  • CPC Certificate
  • Experience working with HSAs

Requirements:
  • (3) years of experience in a similar role or a Bachelor’s Degree
  • Must have (3) years minimum in the health insurance industry
  • (3) years of medical billing and coding required
  • Understanding of health insurance claims and terminology
  • Basic knowledge of Microsoft Office Suite products
  • Aptitude to complete analyst work: Demonstrate ability to problem solve and utilize analysis, experience, and judgement to make accurate decisions.
  • High school diploma or equivalent
  • Background check required
  • Drug screening required

Meet Your Recruiter

Michelle Louden
Senior Director of Client Services

Hi, I’m Michelle, Senior Director of Client Services.  I look forward to connecting with you on your job search.

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