Coordinate Optum TruClaim, ClearHealth Access Network (CAN), and fee negotiations for bill management services, including Zelis code edits and repricing. Support Optum, ClearHealth, and Zelis vendors while ensuring claims are processed, reviewed, repriced, and reported accurately.
This is a full-time work-from-home role.
Requirements & Qualifications
High school diploma or equivalent.
- 2 years of medical claim processing or customer service experience dealing with all types of plans and claims, with consistent performance above required levels
- Strong reading, writing, and verbal communication skills
- Excellent analytical, problem-solving, decision-making, organizational, and detail-oriented skills
- Ability to shift priorities in a rapidly changing environment and work with frequent interruptions
- Strong interpersonal skills and ability to work effectively with employees at all levels
- Ability to take initiative, self-start, and perform project management
- 10-key proficiency of 105 spm net
- Typing speed of at least 35 wpm net
- Ability to work under pressure and meet timelines
- Maintain confidentiality and present a professional business presence
- Proficiency in Facets, Benefit Tracker, and Content Manager
- Knowledge of Moda administrative policies
- Knowledge of medical billing and coding, with the ability to learn and apply these concepts
- Knowledge of clinical editing principles preferred
- CPC certification helpful
- Proficiency with Excel, Word, PowerPoint, internet research, and general PC applications
Benefits & Perks
Medical, dental, vision, pharmacy, life, and disability coverage
- 401(k) matching
- FSA
- Employee Assistance Program
- PTO and company-paid holidays
Location
Portland, Oregon, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago