Employer Service Representative

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CareAllies

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2016

🏥 Healthcare

🤝 B2B

Healthcare • B2B

CareAllies is a healthcare services company that helps physician organizations and health plans succeed in value-based care. It provides business advisory, care coordination, practice and network management, and data/technology support to independent physician associations (IPAs), ACOs, clinically integrated networks and other provider groups. CareAllies focuses on operationalizing value-based contracts (from pay-for-performance to full risk), reducing administrative burden for clinicians, improving patient outcomes, and supporting growth and retention for providers and health plans across commercial, Medicare, and Medicare Advantage arrangements.

📋 Description

• Work with external customers to resolve claim and customer service issues initiated by clients or Client Management • Research and resolve issues • Recommend improvements to processes and procedures to eliminate recurrence of issues or prevent future issues • Communicate with clients, Operations, and Client Management • Track and monitor issues • Service assigned clients as applicable

🎯 Requirements

• High School diploma or GED equivalent • Minimum five or more years claim processing/health insurance industry experience • Ability to work in a fast-paced, customer service driven environment • Excellent verbal and written communication skills • Ability to research topics, summarize findings, and develop recommendations • Ability to work effectively with employees/members, providers, clients, Client Managers, and all levels of staff • Solid understanding of ERISA and DOL regulations • Ability to read, analyze, and interpret documents and Summary Plan Descriptions (SPDs) • Flexible and open to continued process improvement • Self-directed and able to work with minimal supervision • Good leadership, organizational, and interpersonal skills • Demonstrated critical thinking skills • Ability to resolve problems in varying situations • Ability to learn new/proprietary systems and adapt to various system platforms • Effective use of MS Excel and Word • Preferred: Bachelor’s degree • Preferred: Good presentation skills • Preferred: Experience presenting and explaining benefits to a group or one-on-one

🏖️ Benefits

• Curated development plans that foster growth and promote rewarding, fulfilling careers • Health and wellness benefits • 401(k) savings plan • Pension plan • Minimum of 15 days of paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan subject to the terms and conditions of the plan