Issue Resolution Specialist
A successful candidate in this role will exhibit proficiency in taking initiative, attention to detail, communication (verbal and written communication), process orientation, teamwork and accountability.
Specific Duties
Ability to apply initial training concepts while demonstrating the ability to learn new concepts.
· Perform daily investigation of inquiries.
· Provides regular status reports on all outstanding tasks.
· Ensure all Inquiries are researched accurately and resolved timely per department guidelines.
· Monitor each inquiry and follow up regularly and timely as needed.
· Escalate issues as they arise to management (lead and/or above) for communication to clients or partners.
· Interact with all internal and external partners across multiple related departments as needed.
· Identify, track, and report specific trends and issues related to inquiries and system issues.
· Coordinate with Sr, Lead and/or Supervisor on resolution of inquiries.
· Acknowledges each piece of mail and responds to written inquiries either by telephone or letter in a professional manner.
· Effectively resolve all internal requests from diverse areas (via Service Now requests) as directed by Sr and Lead and/or management.
· May perform other duties as required by management.
· Ability to work from home, which includes wi-fi capability and a quiet, confidential workspace.
Ability to work most holidays, flexibility between hours of 8am-6pm and ability to work overtime as needed including weekend and holidays.
Qualifications:
· Knowledge of self-funded health insurance products, Ancillary products, (e.g. Dental, Vision, Prescription), the Affordable Care Act, HIPAA laws, and relevant state laws and regulations.
· Ability to think critically and resolve problems.
· Strong attention to detail and the ability to excel in a high paced environment.
· Proficient with Microsoft Excel, Access, Word, and Outlook.
· Good listening, written and verbal communication skills.
· Ability to multitask and prioritize activities.
· Plan to plan experience is a plus
Education & Experience:
· Associate degree in a Business-related field or equivalent work experience preferred.
· Minimum of 3 - 5 years working within Self-Funded Billing, or Accounts receivable, or Claims, or Enrollment, or Enrollment reconciliation, or Customer Service within the Healthcare industry.
Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
Vaccination Update
This job requires that you demonstrate you have been fully vaccinated for COVID-19 prior to the start of employment, to the extent permitted by law.
About Our Company
AmeriHealth Casualty has been successfully returning employees to work since 1994, providing quality medical treatment and care and reducing costs for our customers. With our affiliates, we serve more than 1,800 businesses in the area and have offices in Philadelphia, Camp Hill, and Pittsburgh, PA, and Mount Laurel, NJ.
In 1994, CompServices, Inc. began offering workers’ compensation third-party administration services for manufacturers, municipalities, health care facilities, social services, transportation risk, universities, and retail firms. In 1996, AmeriHealth Casualty Insurance Company was established as an extension of our workers’ compensation claims services — its mission to provide workers’ compensation insurance combined with high quality claims service and cost containment.
AmeriHealth Casualty Insurance Company and CompServices write premiums and administer self-insured programs for over 1,800 customers.
Equal Employment Opportunity
AmeriHealth Casualty is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth Casualty employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth Casualty and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth Casualty or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.