About Rightway Healthcare
Backed by Khosla.
About the role
This role is located in our Denver Tech Center Office. This is not a remote position. In response to ongoing and industry-wide fraudulent recruitment activities (i.e., job scams), Rightway wants to inform potential candidates that we will only contact them from the @ rightwayhealthcare.com email domain. We will never ask for bank details or deposits of any kind as a condition of employment.
What they're looking for
- Strong communication skills, both written and verbal
- Professional experience with both benefit plan interpretation, provider billing practices, and claim adjudication
- Strong demonstration of critical thinking and problem-solving skills
- Bachelor’s degree in health sciences or related field and minimum of 2 years of experience as a medical claims specialist preferred
More about this role
This role is located in our Denver Tech Center Office. This is not a remote position.
- Determines coverage for medical, dental, and vision procedures by studying provisions of the member’s health policy
- Extracts additional information as required from outside sources, including claimant, physician, employer, hospital, insurance carriers, and other third partners
- Initiates investigation of questionable claims
- Resolves medical, dental, and vision claims and billing questions and issues by
- Provides information on year-to-date deductible, copay, and coinsurance activity to team members
- Maintains quality customer service by following customer service practices and responding to customer inquiries in a timely manner
- Protects claimant information by following HIPAA guidelines
- Reports claim status updates in proprietary CRM and provides detailed information on each claim
Our Navigation Operations is a fast-paced, dynamic, and growing environment. We are looking for individuals who are passionate about concierge service delivery and changing the healthcare experience for consumers.
- Strong communication skills, both written and verbal
- Professional experience with both...
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