Relationship Coordinator
Innova Solutions has a client that is immediately hiring for Relationship Coordinator. Position type: Full-time - Contract Duration: 4 months Location: Philadelphia, PA As Relationship Coordinator, you will be: Resolving common, complex and escalated issues directly impacting provider and member claims. Tracking inquiry information and providing root cause analysis and reports to Management to enable issues to be addressed at a national level. Taking ownership of resolving a partner plan inquiry from start to completion, including when an inquiry requires assistance of another area. Identifying, fixing and eliminating "operational" issues that are identified as trends/patterns of untimely, inaccurate, non-compliant or inconsistent claims adjudication for our participating providers involving multiple system and inquiry platforms. Assessing, recommending, coordinating and facilitating process improvement opportunities for the Commercial and Government Operations business units. Collecting information related to issues and providing recommendations for educational material for members and providers. Managing open inventory both onsite and offsite to meet stringent Association requirements. Receiving, tracking and researching Director level and above escalations for timely resolution in accordance with escalation guidelines. Demonstrated leadership, information driven decision-making, problem solving, organization and planning skills are essential to be successful in this position. The ideal candidate will have: High School Diploma or GED, 4 years' experience in a Claims/Service operations environment or a bachelor's degree, 2 years' experience in Claims/Service environment. Demonstrated understanding of policies, processing standards and guidelines to include Home and Host responsibilities. Demonstrated understanding of all Systems. Demonstrated understanding of Products to include Medicare/Health Plan. Experience in the development, design and execution of account specific, customized education programs in the health care industry - preferred. Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible. Pay Range*: $20- $25 Per hour. *Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work
Innova Solutions has a client that is immediately hiring for Relationship Coordinator. Position type: Full-time - Contract Duration: 4 months Location: Philadelphia, PA As Relationship Coordinator, you will be: Resolving common, complex and escalated issues directly impacting provider and member claims. Tracking inquiry information and providing root cause analysis and reports to Management to enable issues to be addressed at a national level. Taking ownership of resolving a partner plan inquiry from start to completion, including when an inquiry requires assistance of another area. Identifying, fixing and eliminating "operational" issues that are identified as trends/patterns of untimely, inaccurate, non-compliant or inconsistent claims adjudication for our participating providers involving multiple system and inquiry platforms. Assessing, recommending, coordinating and facilitating process improvement opportunities for the Commercial and Government Operations business units. Collecting information related to issues and providing recommendations for educational material for members and providers. Managing open inventory both onsite and offsite to meet stringent Association requirements. Receiving, tracking and researching Director level and above escalations for timely resolution in accordance with escalation guidelines. Demonstrated leadership, information driven decision-making, problem solving, organization and planning skills are essential to be successful in this position. The ideal candidate will have: High School Diploma or GED, 4 years' experience in a Claims/Service operations environment or a bachelor's degree, 2 years' experience in Claims/Service environment. Demonstrated understanding of policies, processing standards and guidelines to include Home and Host responsibilities. Demonstrated understanding of all Systems. Demonstrated understanding of Products to include Medicare/Health Plan. Experience in the development, design and execution of account specific, customized education programs in the health care industry - preferred. Qualified candidates should APPLY NOW for immediate consideration! Please hit APPLY to provide the required information, and we will be back in touch as soon as possible. Pay Range*: $20- $25 Per hour. *Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work