Job Description

New Century Health is leading transformative change in specialty care management. By combining medical management expertise with a deep understanding of healthcare informatics, physician management and healthcare technology systems development, we generate insights that drive leading edge and effective innovation. What does this mean to you? It means that when you join us, you will be a key contributor to one the fastest growing healthcare services in the National Oncology and Cardiology care management space today. With your knowledge, skills and abilities, you will impact the delivery of care and directly contribute to our ability to positively impact and meet the critical unmet needs of patients suffering from all types of cancer.
  
We support our employees with an outstanding benefit package that features programs like employee paid medical benefits, 100% match on your 401k contribution up to 4% of your base salary, generous tuition reimbursement, as well as above average paid time off. If you are interested in working with some of the most dedicated, passionate and smartest people on the planet, express your interest in speaking with us and we will respond immediately.


SUMMARY:
This position plays a vital role in the team’s mission to create and sustain added value to NCH, its Network Partners, Providers, Members and Fellow Colleagues by consistently demonstrating professionalism and excellent customer service. Responsibilities of the role include examining data records, identifying, documenting and correcting errors; Monitors and provides Electronic Data Interchange (EDI) support and resolves issues for internal and external clients; Onboards new Providers; EDI file reconciliation review and reporting; Acts as a liaison to the IT - Claims team and provides oversight of the EDI process; Assists with claims processing responsibilities as needed.


ESSENTIAL DUTIES AND RESPONSIBILITIES:
  • Ability to manage and effectively prioritize fluctuating workload
  • Takes initiative and operates efficiently under minimal supervision
  • Close attention to detail and maintains high level of accuracy
  • Ability utilize adjudication logic to analyze reports and resolve issues
  • Recognizes and solves problems effectively and escalates issues appropriately
  • Ability to summarize technical issues and communicate effectively to non-technical audiences
  • Proficient in Microsoft Office - Excel, Access and Word


EXPERIENCE, EDUCATION, LICENSES & CERTIFICATIONS:
  • Minimum 3 years of claims processing experience in a Managed Care environment (required)
  • Minimum 1 year of EDI file submission and analytical review responsibilities (required)
  • Knowledge of and experience working with 837 files (required)
  • Proficient in Microsoft Office - Excel, Access and Word
  • Bachelor’s Degree (preferred)

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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