Imagine360 is seeking a Client Reimbursement Intake Specialist to join the team! On behalf of clients and members, the Client Reimbursement Intake Specialist works to ensure plan members receive the healthcare services they need. The incumbent will work on the front line to educate providers and members on the full benefits of the health plan and helps to secure the care necessary to meet the needs of each case. The Specialist will also assist in matters related to member navigation and confirmation of benefits and member responsibility.
Position Location: 100% remote
Responsibilities include but are not limited to:
- Understanding of Imagine360, its clients and plans-and Advocacy/Negotiation role therein-will be the key to success in this role.
- Initiate primary provider outreach to explain plan benefits and if possible, resolve case before reaching the Client Reimbursement Advocate.
- Should the case be passed on to an Advocate, member and provider will need to be educated on how we work with plans to successfully secure quality care.
- Research and confirm member benefits and responsibility as necessary.
- Review benchmark/Medicare rates for cases.
- When resolution cannot be secured with the provider, you assist advocates and members to identify alternative provider options.
- Ensure smooth handoff of cases to Advocates by tracking and documenting all communications and efforts on assigned matters.
- In order to build sustainable relationships and trust with clients, you adhere to guidelines, escalate challenges for management review when needed, and maintain open and interactive communication with all key players. With your exceptional customer service skills, you will champion on behalf of the member to ensure fair access to care.
Required Experience/Education:
- Bachelor's Degree
- 1+ years of healthcare, health insurance, or customer service experience.
- Experience with negotiations.
- Experience in billing, insurance, healthcare, or legal environments is a plus.
Skills and Abilities:
- Excellent communication (written, verbal, and listening), interpersonal, and analytic skills
- Knowledge and understanding of CMS1500 and UB04 Medical Claim Forms, medical coding, and proficiency in Microsoft Office products desired
What can Imagine360 offer you?
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- Parental Leave Policy
- 20 days PTO to start / 10 Paid Holidays
- Tuition reimbursement
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**
Bachelor's degree; 1+ years healthcare, health insurance, or customer service experience; negotiation experience; knowledge of CMS1500 and UB04 forms, medical coding, and Microsoft Office preferred.
Key Responsibilities
- educating providers and members
- confirming member benefits
- documenting communications
Skills & Tools
Microsoft Office, CMS1500, UB04
Job Details
- Category: Customer Service
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
Benefits
- 401k matching
- Generous paid time off
- Tuition reimbursement
- Retirement plan
- Generous parental leave
About Imagine360
A health plan solution company combining 50+ years of self-funding healthcare expertise to help employers save on healthcare. — Industry: Healthcare