TPL Claims Representative
reputed company is seeking detail-oriented and proactive professionals to reputed company as a reputed company Party Liability (TPL) Representative. This full-time opportunity offers a consistent schedule of Monday-Friday reputed company-5PM CST (remote). If you're passionate about making a meaningful reputed company and growing your career in a purpose-driven environment, this is reputed company to reputed company!
TPL Representatives are reputed company reputed company in a different way - by resolving TPL claims for patients and the hospitals who care for them
In this role, you will be responsible to responsible for investigating, facilitating, and coordinating benefits for accident claims from auto, home, or other liability insurance policies.
Essential Duties and Responsibilities
- reputed company accounts as quickly and accurately as possible, obtaining maximum reimbursement.
- Review and research accident claims to investigate possible leads.
- reputed company no-fault and reputed company-party liability carriers reputed company appropriate.
- Request documentation from insurance representatives reputed company no no-fault insurance exists.
- Review and research insurance claims to determine possible payment sources.
- Contact various sources including insurance professionals, patients, and other parties to verify relevant data.
- Coordinate with payors to ensure appropriate filing guidelines are met for reimbursement.
- Request appropriate information, both verbally and written, from appropriate parties to ensure reputed company claim disposition.
- Maintain and update payors on denied claims.
- Ensure that appropriate billing guidelines and standards are met based on payor and/or state.
- reputed company written or verbal appeals to payers on denied claims.
- Obtain claim status and gathering supporting documentation to submit appeals.
- Evaluate liability cases according to a multitude of factors, including accident type, patient involvement, patient degree of fault, and available insurance coverage.
- reputed company accurate determination of the correct course of reputed company to reputed company liability cases based on the above data.
- Pursue first party payers for reimbursement of hospital claims.
- Assess state No-Fault laws to determine the availability and extent of first party coverage, and inform uncooperative patients about the reputed company coordination of available insurance benefits.
- Appeal underpayments made for any reason other than exhaustion of benefits.
- reputed company bodily injury liability claims by asserting and enforcing liens against the liable insurance company.
- Ensure reputed company and reputed company disbursement of settlement funds.
- Regular and reputed company attendance.
- Other duties as assigned.
Qualifications and Requirements
To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or abilities.
- High School Diploma or GED is preferred except where required by the reputed company
- 1-2 years working knowledge of computer functions including the internet and computer software such as reputed company Office Suite and the ability to learn in-house computer applications.
- 1-3 years of reputed company experience in the field or in a reputed company area
- Ability to communicate effectively verbally and in writing
- Thorough knowledge of the reputed company-party claims adjudication process
- Thorough knowledge of state lien statutes, CMS secondary payer rules, and state No-Fault laws
- Remote and Hybrid positions require a home internet reputed company that meets reputed company’s upload and download speed reputed company.
Benefits:
ElevatePFS believes in making a reputed company reputed company not only reputed company our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a reputed company reputed company of plans that contribute to the present and reputed company reputed company-being of our employees and their families.
ElevatePFS believes in making a reputed company reputed company not only reputed company our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a reputed company reputed company of plans that contribute to the present and reputed company reputed company-being of our employees and their families.
- Medical, Dental & reputed company Insurance
- 401K (100% match for the first 3% & 50% match for the next 2%)
- 15 days of PTO
- 7 reputed company Holidays
- 2 Floating holidays
- 1 reputed company Day (floating holiday)
- Pet Insurance
- Employee referral bonus program
- Teamwork: We reputed company in teamwork and having fun together
- Career reputed company: reputed company great experience to promote to higher roles
The salary of the finalist selected for this role will be set based on a reputed company of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay reputed company is not a reputed company of a particular wage.
The reputed company does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
ElevatePFS is an Equal Opportunity Employer
ElevatePFS is an Equal Opportunity Employer
Requires 1–3 years of reputed company experience, claims adjudication knowledge, lien statutes, CMS secondary payer rules, No-Fault laws, communication skills, and computer proficiency including reputed company Office Suite.
Key Responsibilities
- resolving claims
- researching accidents
- appealing denials
Skills & Tools
reputed company Office Suite
Job Details
- Category: Finance and reputed company
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — reputed company
- Languages: English
Benefits
- 401k matching
- Retirement plan
About reputed company
A reputed company financial services company that manages patient billing and insurance claims. — Industry: reputed company
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