Associate, Claims Support Services

At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for an Associate, Claims Support Services to join #TeamMVP. If you have a passion for Data driven decision making, Being Curious, and Research and problem solving, this is the opportunity for you.

What's in it for you:

• Growth opportunities to uplevel your career

• A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team

• Competitive compensation and comprehensive benefits focused on well-being

• An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work for and one of the Best Companies to Work For in New York

Qualifications you'll bring:

• A High School Diploma required. Associate's in health, Business or related field preferred. Relevant work experience may be substituted for degree or equivalent combination of education and related experience
• Previous medical claims processing experience required. Knowledge of CPT, HCPCS, ICD-9-CM coding systems and medical terminology.
• The availability to work full-time, Virtual in New York State

• Curiosity to foster innovation and pave the way for growth

• Humility to play as a team

• Commitment to being the difference for our customers in every interaction
• Strong Verbal and Written Communications
• Critical Thinking and Problem Solving

* Adaptability

* Strong Time Management

* Ability to sit at a computer for an extended period of time.

Your key responsibilities:

• Ensuring great member and provider experience by accurately and efficiently processing claims adjustments, while concentrating on putting our customers at the center of how Operations operates.

• Ensures accurate and timely processing of claim adjustments/service forms and ad-hoc projects/retro database items in accordance with medical and ancillary guidelines and benefits.

• Acts as a liaison with other department and outside vendors to resolve claim issues as they arise while also conducting root cause analysis on those issues with a focus on improving the member and provider experience.

• Completes daily reports as needed with flexibility to move from one project to another on a daily/weekly basis.

• Evaluates all business processes to proactively identify efficiency opportunities and partners with team leads to implement production and quality standards, identify trends and recognize process improvements with a focus on continuous improvement.

• Will work to reduce the number of complaints, appeals and DFS issues along with improvement in the average turnaround time and reduction in the number of hand-offs within the organization

• Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where you'll be:

Virtual within New York State

Pay Transparency
MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

We do not request current or historical salary information from candidates.
MVP's Inclusion Statement
At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.

MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.

To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at hr@mvphealthcare.com.

• Headquarters Office, 625 State Street, Schenectady, New York, United States of America
• Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America