JOB TITLE                     Research & Resolution Analyst

 

POSITION OVERVIEW

This individual is a liaison for the TC³ clients and the networks. The Research and Resolution Analyst is assigned a client base. The analyst must have excellent communication skills both written and verbal and be detailed oriented with solid problem solving and decision-making skills.  Analyst is responsible for managing client and network inquiries in a professional and timely manner, as well as addressing complex issues and resolving them effectively through interaction with internal departments and/or external contacts.

 

RESPONSIBILITIES

·         Accountable for PPO provider disputes/inquiries

·         Resolve disputes/inquires in a timely manner

·         Identify dispute patterns

·         Answer 800 customer service numbers assigned to certain clients

·         Track adjustments for accounting purposes

·         Maintain weekly disputes Excel spreadsheets at the client request/requirements

·         Must address and/or resolve a minimum number of claims per day (details will be provided)

·         Update Provider TIN Exclusion list

·         Build a good working relationship with the network partners and clients

·         Assess current process and procedures; make recommendations for improvement and implement such changes if/when necessary

·         Other duties as assigned

 

KNOWLEDGE AND SKILL REQUIREMENTS

·    Proficient in Microsoft Word, Excel, Outlook

·   Great communication skills both verbal/written

·   Outstanding customer service skills

·   Excellent organizational skills

·   Detail oriented with solid problem-solving and decision-making skills

·   Strong interpersonal skills; ability to work well with others and independently

·   Previous experience in client service health claims and insurance preferred

SALARY RANGE               DOE

 

CONTACT EMAIL              csjobs@tc3health.com