Payer Enrollment Specialist - Full Time
Big HealthSalary not specified
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, InsuranceIndustries
Requirements
- Exceptional leadership abilities
- In-depth knowledge of Payor Enrollment subject matter, including Medicaid/Medicare and Commercial (Medical or Behavioral Health)
- Strong commitment to efficiency and accuracy
- Amazing at coaching, mentoring, and growing team members
- Passion for driving metric improvement through detailed process analysis and understanding key company metrics
- Hands-on approach with short-term tactical execution and long-term strategic thinking
- Strong organizational skills
- Proven ability to manage multiple projects simultaneously and effectively prioritize critical tasks
Responsibilities
- Lead team to consistently meet daily and weekly objectives, ensuring timely, high-quality task completion while managing increasing workloads
- Guide team of Operations Analysts, supporting their daily activities to guarantee accurate and high-quality execution of Payor Enrollment tasks and application procedures
- Track team's submission volume to ensure completion of assigned tasks and enrollments
- Communicate with Payor Enrollment Management to distribute tasks among the team as needed
- Coordinate with Operations Management during performance reviews to determine performance ratings for Operations Analysts
- Educate and support new team members during their training
- Assist Operations Management in accountability for core performance metrics (speed, quality, efficiency of file processing) for assigned clients
- Ensure all files managed by the team meet client Service Level Agreements (SLAs) and exceed quality standards
- Coordinate with Payor Enrollment Management to prioritize highest priority files and equip team to work on them
- Review and share team performance data daily and weekly with management (upwards), team (downwards), and peers (laterally)
- Submit enrollment applications for groups and/or providers to facilitate adherence to client SLAs
Skills
Payer Enrollment
Medicaid
Medicare
Commercial Insurance
Team Leadership
Operations Management
Performance Metrics
SLA Compliance
Employee Training
File Processing
Assured
Digital solutions for insurance claims processing
About Assured
Assured.Claims provides digital solutions specifically for Property and Casualty (P&C) insurance carriers, focusing on enhancing the claims process. Their platform allows insurers to manage claims digitally, utilizing a combination of artificial intelligence and human interaction to facilitate effective communication with all parties involved. A key feature of their service is the First Notice of Loss (FNOL) web app, which helps insurers collect structured data at the beginning of a claim, leading to improved customer experiences and faster claim resolutions. Assured.Claims differentiates itself by offering a white-label solution, enabling insurers to implement their technology under their own brand without needing to develop it themselves. The company's goal is to streamline the claims process for insurers, ultimately improving efficiency and accuracy in claims handling.
Palo Alto, CaliforniaHeadquarters
2019Year Founded
$4.3MTotal Funding
SEEDCompany Stage
Fintech, AI & Machine LearningIndustries
51-200Employees
Benefits
Competitive salary & equity packages
Medical, dental, & vision
Life Insurance
PTO (Uncapped vacation days & paid holidays)
Family Leave
401(k) contribution
Commuter Benefits (Tax-advantaged commuter benefits account)
Health & Dependent Care FSAs (Pre-tax flexible spending accounts for out-of-pocket expenses)
Risks
Rising competition from new insurtech startups could erode Assured.Claims' market share.
Regulatory scrutiny on AI claims processing may increase compliance costs.
Data privacy concerns could lead to reputational damage for Assured.Claims.
Differentiation
Assured.Claims offers a unique FNOL web app for structured data collection.
The company provides a white-label solution for insurers to brand their own technology.
Assured.Claims combines AI and human interaction for empathetic claims communication.
Upsides
Increased AI adoption enhances claims process with 24/7 support and reduced response times.
IoT integration allows real-time data collection, improving claims accuracy.
Remote work trends drive demand for digital claims solutions, boosting Assured.Claims' market.
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