The impact you will make

We are looking for a dynamic Healthcare Operations Representative to assist our clients in completing payer enrollments in order to successfully submit and receive electronic EDI transactions.  You will be expected to effectively communicate with the appropriate stakeholders throughout the enrollment process cycle.  As a Healthcare Operations Representative, you will be responsible for managing customer support queues to ensure items are acknowledged and routed to the appropriate teams quickly and efficiently.  You will also be responsible for researching and resolving inquiries from clients related to user access requests, assisting with invoicing inquiries and appropriately responding to general questions of low to moderate complexity.  At the direction of management, you may take the lead on projects of various size and scope within your area of responsibility and control.

What you will do

• Monitor and manage work queues to ensure inquiries are routed to the appropriate team members with speed and accuracy.
• Respond timely to queries from clients and insurance companies through email and telephone as appropriate.
• Troubleshoot and provide analysis, support and guidance on all issues related to payer enrollments, user access requests, invoices and other general questions.
• Assist portal clients with user account management and permission requests.
• Work with clients, payers and intermediaries to ensure proper enrollment for electronic healthcare responses and facilitate resolution of payer enrollment denials.
• Maintain and document enrollment processes and procedures, including payer/intermediary application processing timelines and requirements.
• Proactively identify potential enrollment issues based on provider type or payer type.
• Develop and maintain both internal and client-facing documentation.
• Communicate issues to management regarding payer, system or escalated account issues.
• Assist Operations Support Analysts in resolving various routine requests from clients.
• Participate and attend meetings and in-house trainings to develop and expand job knowledge.
• Client requested meetings
• Phone support
• Perform all other related duties as assigned.

What you will bring

• Graduation Degree or equivalent
• 0-3 years of related work experience in the healthcare industry or customer service industry preferred.
• Ability to read, analyze, and interpret professional journals, technical procedures, and governmental regulations
• Strong written / verbal communication, interpersonal, and relationship skills
• Ability to work in a team environment that requires quick turnaround and quality output
• Knowledge of HIPAA, EDI and Healthcare X12 transactions is a plus.
• Must be proficient with personal computers and related software applications such as Microsoft Office Suite 
• Ability to adapt quickly to new technologies, processes and changing priorities 
• Understanding of and experience in supporting continuous integration/continuous deployment 
• Collaboration skills to gather input and then experiment with available solutions to validate assumptions and feasibility. 
• A team-oriented mind set 
• An enthusiastic, can-do attitude, problem solving skills and a relentless improvement mindset. 
• Excellent organizational and time management skills 
• Travel required: None. 

What we would like to see

• Excellent verbal and written communication skills, with the ability to present information within a public setting. 
• Experience in the healthcare industry.
• Customer service experience preferred.
• Salesforce.com experience is a plus.
• Knowledge of claims rejections/denials experience a plus

About FinThrive
FinThrive is advancing the healthcare economy.
For the most recent information on FinThrive’s vision for healthcare revenue management visit finthrive.com/why-finthrive