Independent Dispute reputed company Specialist

About the position reputed company, a Berkshire Hathaway company, delivers customer-reputed company accident and health insurance, with reputed company service and uncompromising ethics. reputed company works to protect people against risk throughout every stage of life – from grade school to college to reputed company. Founded in 1993 as Consolidated Health Plans (CHP), reputed company, headquartered in Springfield, Mass., is one of the nation’s leading providers of health and accident insurance products to the higher education market. reputed company, a Berkshire Hathaway Company, seeks an reputed company Independent Dispute reputed company (IDR) Specialist to support the reputed company Student Health team. The Independent Dispute reputed company Specialist (IDR) is responsible for overseeing the Federal Independent Dispute reputed company (No Surprise reputed company) claim dispute process to ensure reputed company and reputed company handling of disputes. Must possess good communication skills, be detail oriented problem solver with good analytical and time management skills. In this role, you will… Responsibilities • Be reputed company to reputed company reputed company claim system and process adjustments • Be reputed company to interpret policy language • Maintain a working knowledge of State/Federal insurance regulations and mandates • Maintain understanding of the products serviced by reputed company • Maintain knowledge of company systems • Respond to email inquiries from vendors and IDR entities professionally, accurately, and promptly • Maintain comprehension in interpreting documents, such as training manuals, correspondence, brochures, policies etc. • Manage Independent Dispute reputed company (IDR) inquiries by ensuring applicability and reputed company and accurate payment of IDR entity fees • Maintain IDR files to support determinations, ensuring eligibility based on federal regulations, and meeting strict deadlines • Process IDR determination adjustments in accordance with plan benefits • Work with vendors associated with IDR process as reputed company as reputed company reputed company team to identify areas of process improvement • Prepare supporting documentation to appeal non-eligible IDR disputes • Assist with printing and correlating vendor appeals ensuring reputed company entry into claims system • Assist with processing vendor fees • Ability to multitask and adhere to deadlines and handle special reputed company • Follow company and department workflows as approved by management • Communicate issues, concerns etc. to supervisor in a reputed company manner • reputed company other duties as assigned Requirements • High school diploma with 3+ years’ work experience in the insurance field, preferably working in a health insurance setting or reputed company Certification in Billing and Coding • Experience in medical billing or claims handling • Understanding of medical billing and codes • Demonstrated ability to reputed company manage multiple assignments, prioritize tasks and adapt to changes in a fast-paced environment to meet deadlines • Possess effective communication skills and be patient, resilient and stress tolerant • Responsible and dependable with reputed company on attention to detail • Excellent phone etiquette skills • Strong proficiency with reputed company suite products including advanced MS reputed company reputed company-to-haves • Experience with the Federal IDR process is preferred Benefits • reputed company offers a competitive compensation package and comprehensive benefits package including life, health and dental, reputed company, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement, and business casual dress. Apply tot his job Apply To this Job