Call Center Customer Service - Claims

Location: New York, NY

Department: Claims

Type: Full Time

Min. Experience: Entry Level

The Company

Integra Partners is a leading, tech-enabled, healthcare benefit management company focused on community-based care. Integra has a core competency in Durable Medical Equipment (DME), Orthotics and Prosthetics (O&P), and works with providers and health plans to facilitate care for hundreds of thousands of patients each year.  We have experienced rapid growth with no slowdown in sight.

Our leadership team is amazing (www.accessintegra.com) and focused on what really matters to our business - every employee, every experience, and every customer. With the right people, success is unbounded. This is a truly unique opportunity to take a position with a great company, surrounded by an awesome team.

In 2015, Integra’s management and Tufts Health Plan of Massachusetts acquired the business. Tufts Health Plan is one of the country’s leading, 5-star, private health plans providing healthcare to individuals and employer groups. Integra now operates as a separate financial investment and subsidiary of Tufts Health Plan with a separate board of directors and governance structure. Integra is an innovative and exciting company, with an entrepreneurial culture focused on teamwork and everyday excellence.

Scope and Responsibility

Integra works with hundreds of healthcare providers to help facilitate the care of over 150,000 patients per year. One of our key functions is to ensure timely and complete payment from third party payors. We are looking for a Call Center Customer Service - Claims to perform activities that maximize insurance reimbursement, promote faster payment and offer exceptional customer service.

Key Responsibilities and Essential Functions

  • Day-to-day, front line interaction with providers via telephone, email, and fax
  • Provider support including status updates on all open claims over 30 days and ensure any necessary actions are communicated to providers in a timely fashion
  • Identify and correct provider billing errors and rejected claims
  • Train providers on protocol pertaining to claims department and billing program
  • Review open accounts requiring collections and make outbound collection calls
  • Resolve billing issues and assist with accounts receivable delinquencies
  • Identify issues attributing to account delinquency and discuss solutions with management
  • Review and monitor assigned accounts and all applicable collection reports
  • Provide timely follow-up on payment arrangements
  • Answer on average 30 calls per day
  • Respond to on average 50 – 60 emails per day
  • Maintain a 90% or higher quality assurance score on calls and emails 

Requirements

  • High School Diploma required; 4 year degree or equivalent experience
  • Bilingual Spanish, Bilingual Cantonese, Bilingual Mandarin, Bilingual Polish preferred
  • 2+ years’ experience billing/collecting receivables for DME and/or O&P companies preferred
  • Familiarity with ICD-10, HCPCS, and medical terminology
  • Proficiency with using practice management software
  • Flexible and able to multi-task and work with changing priorities with urgency and enthusiasm
  • Exceptional communication skills – verbal and written / English fluency (verbal and written) is a must
  • Computer skills – Microsoft Word, Excel and ability to type 45 wpm
  • Highly detail oriented with an emphasis on accuracy
  • Maintain an attitude of responsibility, ownership and accountability
  • High energy and passion with a customer and client focused mentality
  • Have a pleasant telephone personality
  • Conduct yourself in a courteous, helpful, and professional manner at all times when dealing with patients, co-workers, supervisors and or the public
  • Outstanding organizational and multitasking abilities
  • Active listener with excellent communication skills
  • Sound judgement and critical thinking
  • Passion for your work and the mission of the company
  • Motivated and able to work independently within a fast paced, team environment
  • Prior experience in a call center preferred
  • Must follow policies regarding attendance and punctuality
  • Ability to work overtime as required

Integra Perks

  • Competitive compensation with bonus opportunity
  • 401k eligibility
  • Medical, Vision, Dental Benefits
  • Standard business hours, Monday – Friday
  • Paid Time Off (PTO) 90 days after hire
  • Collaborative and engaging office environment
  • Opportunity to be a key member of a rapidly growing company
  • Company sponsored events (holiday parties, sporting events, team building activities)
  • Company and department specific trainings

It is the policy of Integra Partners to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Integra Partners will provide reasonable accommodations for qualified individuals with disabilities.

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