4 DAYS AGO
Full Time | Work From Home
Full Time | Work From Home
Mitchell, Genex and Coventry
With Mitchell, Genex and Coventry now one organization, we’ve dramatically expanded our ability to deliver innovative services and technologies to our customers. We’ve also seen career opportunities within our combined organization grow. Each part of our organization helps people recover after a challenging event in their lives.
Mitchell delivers trusted software and services to the property & casualty claims, collision repair and risk management industries with technology-enabled solutions that simplify claims handling, repair processes and pharmacy transactions. Genex helps injured workers return to their jobs in a safe and efficient manner through compassionate case management, reducing health care costs and disability expenses for our customers. Coventry offers the nation’s largest and most diverse set of provider and ancillary networks focused on improving total overall outcomes.
Together , we bring a complete set of proven capabilities for our partners who require more than one-dimensional solutions. We combine innovative technology, insightful analytics and deep expertise to help them reach their ultimate goal—restoring lives.
Job Description
This is a full-time, remote position that can be located anywhere in the U.S.
Provide comprehensive Workers’ Compensation cost and care management solutions for property and casualty insurance carriers, third-party administrators, and self-insured employers by designing best-in-class products and services to help our partners restore the health and productivity of injured workers and the insured as quickly and as cost effectively as possible.
• Effectively and successfully processes all work specific to legal/state medical bill disputes with a working knowledge of bill review processes such as Network Contract Pricing, Provider Customer Service, or other operating groups/areas.
• Effectively communicates in writing and on the phone with clients, providers, or attorneys to assist with problem identification and/or resolution to achieve customer satisfaction.
• Processes work according to necessary deadlines and to allow for reporting on a weekly and monthly basis.
• Escalates issues related to regulatory, software, and/or business rules to supervisor when problems or trends are identified within the established processes and workflows.
• Participates on internal conference calls as required.
• Performs other duties as required.
Home Office Requirements:
• Requires DSL, fiber or cable internet connection from home. 1 Mbps preferred or better.
• Home office must be HIPAA compliant.
The State Disputes team is part of the Network Operations team. Members of the State Dispute team provide responses to escalated legal and state disputes related to medical bill review for Coventry's clients.
Qualifications
• High School Diploma or G.E.D.
• Knowledge of ICD-10 and CPT codes required.
• Previous (3-4 years) claims processing in a PPO network platform.
• Effective keyboard skills; able to navigate within a computer/systems-dependent environment without assistance
• Microsoft Office: Word, PowerPoint. and Excel, strong Outlook skills required.
Benefits
We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living.
The Company is an equal opportunity employer, values the diversity of our workforce and the knowledge of our people. The Company does not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law.
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Location/Region: Tampa, FL (33646)