CareCentrix

  • Network Services Advocate I

    Job Locations US-CT-Hartford
    Job ID
    2020-8597
  • Overview

    Do you want to make a difference and help patients heal and age at home? CareCentrix is committed to making the home the center of patient care.

     

    We are currently hiring for several Network Services roles in our Hartford, CT location.  This position receives/responds to in- and out-of-network provider inquiries on claim status (payment, denials, rejections, appeals, recoupments, etc.), education on Explanation of Payments and provider portal questions, and other concerns and/or complaints. The appropriate resolution is provided via researching information by reviewing plan, eligibility, and authorizations. Works with Client Services and Revenue Cycle departments to identify areas of opportunity and recommend solutions.  

     

    CareCentrix is a certified Great Place to Work employer. We offer extensive and competitive compensation and benefits with excellent career opportunities. 

     

    Responsibilities

    • Handles various communication channels with providers, including inbound and outbound provider calls which involve researching, resolving, and documenting issues.      
    • Analyzes data and determines if CareCentrix claims processing guidelines have been followed correctly by researching plan, eligibility, and patient authorization information. 
    • Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
    • Accurately identifies complaints and escalates accordingly.
    • Participates in and contributes to performance improvement activities.
    • Participates in special projects and performances other duties as assigned.

    Qualifications

    • Requires a High School Diploma or the equivalent.  Must have minimum 1 year work experience.
    • 2 years of customer service, claims processing, medical terminology, medical services or equivalent experience strongly preferred.  
    • Candidate must demonstrate empathy and excellent communication skills both verbal and written. 
    • Ability to multi-task, be detail oriented, responsive, with critical thinking skills.
    • This position requires customer service and problem solving skills, as well as the ability to interact with all levels of management.  

    CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.

     

    We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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