Statement of the Position:

Because of our commitment to client satisfaction, ClarisHealth has grown into an industry leader. The driving force behind this success is our unwavering belief in the ClarisHealth DNA; compassion and seek to understand, communicate with transparency, and challenge the status quo.

This role will be responsible for ensuring customer satisfaction by providing timely responses and solutions to our services clients, effective and efficient provider engagement regarding appeals on claim audits, and supporting end of month financials and invoicing on behalf of ClarisHealth Services Operations.

Duties and Responsibilities / Essential Functions:

• Provide accurate inventory tracking and reporting on all appeals and recoveries.
• Completion of appeal requests and associated tracking.
• Participating in the effort to move all appeals tracking into the Pareo Platform
• Facilitation of assigned client calls, maintaining an ongoing agenda and providing prompt responses and solutions to their needs.
• Commitment to professional development.

Position will be measured by using the following performance standards:

• SMART Goals
• Client Satisfaction
• The following Key Performance Indicators:
  • 24 hours response on all appeals
  • Timely provider follow-up according to date stamps in Pareo
  • Appeal overturn rate under 5%
  • 100% accuracy for all client invoicing

Competencies:

• Ability to prioritize impeding tasks, and delivering on or before target dates
• Strong communication skills
• Ability to offer creative solutions, challenge the status quo, and think outside the box
• Intermediate technology skills
• Initiative/Results Driven
• Organizational Skills
• Customer/Client Focus
• Attention to detail

Required Education and Experience:

• 3-5 years or healthcare front office, or similar, experience required.
• Microsoft Office

Other Duties:

This job description in no way states or implies that these are the only duties to be performed by this employee. This position will require you to follow any other instructions and to perform any other duties requested by his/her supervisor. Individuals will always be expected to maintain a professional work environment.