claims representative

claims representative Arizona

Centauri Health Solutions
Full Time Arizona 19.8 - 15 USD HOURLY Today
Job description

claims

Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com.

Role Overview:
Our company helps hospitals and health plans improve their revenue and deliver community benefits. On their behalf, we help their patients and plan members with low or no income, and those who are aged or disabled, to enroll in government-funded assistance programs.
Disability Specialists work in a fast-paced, multi-tasking, contact center environment, managing both inbound and outbound calls.
Disability Specialists will handle all submitted Social Security applications from beginning to end while providing claimants with outstanding customer service and support and will work closely with Social Security offices nationwide.
The Disability Specialist will coordinate appointments, provide resources and materials, and provide medical updates to Disability Determination Services and private institutions.
A successful Disability Specialist is an empathetic communicator, likes to juggle multiple projects, is detail oriented and, above all, is compassionate.

Role Responsibilities:
  • Maintains regular communication with claimants, answers questions regarding the application, services, and benefits and clarifies eligibility data
  • Will manage all inbound and outbound queue calls while staying on top of own tasks
  • Assists in gathering eligibility data, verifications, completed forms and medical records.
  • Manages positive professional relationships with agencies and clients.
  • Submits documents/applications to proper agencies; follows up appropriately with all entities to ensure processing and stays updated on status of claims.
  • Manages all accounts and taking appropriate action to secure eligibility until all methods are exhausted.
  • Secures and submits all necessary signed SSA forms and any missing verifications
  • Contacts providers / secures medical records as needed
  • Is thoughtful and proactive to anticipate and foresee key requirements for all accounts and takes appropriate action to secure eligibility until all methods are exhausted
  • Works with government agencies/physician offices to obtain coverage for clients
  • Maintains positive professional relationship with agencies and clients
  • Understand and agree to role-specific information security access and responsibilities
  • Ensure safety and confidentiality of data and systems by adhering to the organizations information security policies
  • Read, understand, and agree to security policies and complete all annual security and compliance training
Role Requirements:
  • 2 years of Customer Service
  • Must be fluent in Spanish (speak, read, write)
  • Excellent communication and interpersonal skills with an ability to clearly communicate and influence
  • Call Center experience and/or De-Escalation experience a plus
  • Experience working with government agencies a plus
  • Experience in Social Services, case management, processing disability/claims evaluation and/or adjudication, and Medicaid/Medicare knowledge a strong plus
  • Strong interpersonal skills and ability to work in a team environment
  • Detail Oriented, Willing to Learn, and Goal Driven
  • Ability to multi-task and manage time appropriately
  • Strong computer skills, proficiency with Microsoft Word, Excel and Outlook, and ability to navigate multiple platforms and screens smoothly
We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities. This position is bonus eligible in accordance with the terms of the Company’s plan.

Centauri currently maintains a policy that requires several in-person and hybrid office workers to be fully vaccinated. New employees in the mentioned categories may require proof of vaccination by their start date. The Company is an equal opportunity employer and will provide reasonable accommodation to those unable to be vaccinated where it is not an undue hardship to the company to do so as provided under federal, state, and local law.

Factors which may affect starting pay within this range may include geography/market, skills, education, experience and other qualifications of the successful candidate.

This position is bonus eligible in accordance with the terms of the Company’s plan.

claims representative
Centauri Health Solutions

www.centaurihs.com
Scottsdale, AZ
Adam Miller
Unknown / Non-Applicable
1001 to 5000 Employees
Company - Private
Computer Hardware Development
2014
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