Customer Claims/Medical Billing 29 An Hour Starting - HIRING NOW
 TEKsystems | |
$20.00 / hr
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life insurance, sick time, 401(k), retirement plan
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 United States, Hawaii, Honolulu | |
 Mar 28, 2025 | |
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* Grievance and Appeals Process
* * Coordinates the timely completion of HDS's grievance and appeals process, including acknowledging, researching, and resolving complaints and appeals from HDS members and dentists. Utilizes comprehensive understanding of various claims payment scenarios for Medicaid, Medicare, and Commercial lines of business, HDS procedure code guidelines, diverse dentist office billing formats and practices, in-depth clinical explanations, the dentist/patient relationship, and HDS provider regulations. Reviews, researches, and analyzes HDS claim payments, patient billing and payments, patient records, clinical notes maintained by the dental office, and potential discrepancies in patient billing and/or records to determine corrective action steps. * Researches, investigates, and reports possible situations of fraud and abuse during the investigation of a grievance or appeal. * Training * * Provides quality training and onboarding for new Customer Service Representatives. Utilizes side-by-side coaching and recorded call data to provide constructive feedback and quality assurance to new and existing call center representatives. Develops training curriculum for the Customer Service department. Creates refresher training material for Customer Service team members. Updates SharePoint as a common knowledge base and for ease of use and access. * Acts as the department liaison to Claims Processing, Membership Services, Billing, Professional Relations, Sales, Marketing, Underwriting and/or Information Systems for process/system improvements to enhance the overall customer experience. Coordinates interdepartmentally to understand and mitigate periods of high call volume. Implements short term and long-term solutions to help reduce incoming call volume. * During system outages, assists with implementing workaround processes, interdepartmental communications and normalizing call center operations, post-outage. WEST: #prioritywest #westpriority25 *Pay and Benefits* The pay range for this position is $20.00 - $20.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type* This is a fully onsite position in Honolulu,HI. *Application Deadline* This position is anticipated to close on Apr 10, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. | |