Provider Pricing Specialist

Company: Health Plans Inc
Location: Westborough
Posted on: June 24, 2022

Job Description:

Job Description** $750 Sign-On Bonus Available**Do you envision working for a company that has the expertise of a long-standing industry leader, but the spirit of an entrepreneur? Does the thought of making a real impact motivate and energize you? If so, then HPI is the place for you. Join a team that values integrity, flexibility, loyalty, compassion and dedication—we can't wait to meet you. What we doHPI is unique. A respected industry leader that's been serving customers for over 40 years, we're known for our innovation and growth. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you'll contribute to ideas that make a real difference for employers and employees nationwide. There isn't a challenge we won't accept and we're looking for people who have a passion to take it on. Not just a job—a mission. What you'll doWe're looking for a detail-oriented data expert with excellent communication skills and a background in medical billing and coding to join our Technical Resource Unit. In this role, you'll manage provider database information, provider association with claims and the setup of customer portals. You'll also assist with research to settle claim pricing questions, as well as the provider and member appeal process. In this role, you'll also:

• Create morning reports and monitor queues to manually handle problematic matching Maintain and update provider records for electronic remittance advice and electronic fund transfers
• Audit reports to ensure data integrity
• Watch for and communicate trends, discrepancies or changes that could affect how a claim is priced or paid
• Respond to CSIpac provider inquiries and HPHC provider escalations
• Contact hospitals and providers to verify information and ensure accurate updates
• Test new releases in our core system, Healthware The ideal candidate has:
  • A High School Diploma or equivalent
  • The ability to work independently and as part of a team
  • The ability to prioritize tasks, work within timeframes and meet deadlines
  • The ability to recognize and maintain confidentiality and communicate in a professional manner
  • Proficiency with Microsoft Word and Excel (required)Bonus points if you: Prior experience with medical terminology and/or billing and coding Why choose us?
    • Our space is a reflection of who we are—innovative, open and collaborative.
    • Love to get creative? We do too. Let the juices flow and brainstorm in one of our team break-out rooms.
    • We think feeling your best is an important factor in producing great work, so we embrace a "smart casual" dress code and work at ergonomic desks.
    • Need to reenergize? Take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms.
    • We offer our employees incredible health coverage, a 401(k), employer-paid disability, EAP, hybrid work arrangements (depending on the position), and quarterly bonuses.
    • We're a people-first company and value giving back to our community. Ask us about our employee mini-grant program and volunteer opportunities. So, think you want to join the HPI team? We hope to hear from you! You can read more about us at hpitpa.com/about-us/careers/ HPI is subject to the Occupational Safety and Health Administration's Emergency Temporary Standard and regulations regarding vaccination and testing in the workplace. HPI has established policies and procedures consistent with the applicable standards and regulations as amended or revised from time to time.EEO/AA/M/F/Vet/Disability Employer

Keywords: Health Plans Inc, Worcester , Provider Pricing Specialist, Other , Westborough, Massachusetts