Claims Resolution Specialist

hace 5 días


San Francisco, Heredia, Costa Rica Auxis A tiempo completo

Job Summary:

Auxis is a fast-growing business process outsourcing provider that supports leading healthcare services. As an Appeal Discrepancy Collector, you will be part of a team responsible for researching and resolving Underpayments.

Main Responsibilities:

  • Validate discrepancy reason coding of underpayment inventory
  • Pursue additional payment from payers through various means of communication
  • Overcome objections to prevent payment of the claim
  • Gain commitment for payment using concise and factual collection techniques
  • Communicate trends to management as identified
  • Facilitate correction of non-payment related underpayment discrepancies
  • Escalate accounts to appropriate individuals at the payer and via SSC management
  • Utilize effective documentation standards to support historical records
  • Meet productivity and quality standards of the organization

Required Skills and Qualifications:

  • Effective communication skills
  • Strong customer orientation
  • Interpersonal skills
  • Policies and procedures knowledge
  • Basic math skills and attention to detail
  • English-Spanish language proficiency (B2+ or above)
  • High school diploma or equivalent
  • At least 6 months of experience in Customer Service positions

Benefits:

  • Health benefits including medical, vision, and dental
  • Transportation subsidy
  • Asociacion Solidarista
  • Training and development programs
  • Employee recognition program
  • Paid time off and family-paid leave
  • Paid day off for your birthday


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