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Provider Correspondence Coordinator I - Internal Applicants Only
- Job Title
- Provider Correspondence Coordinator I - Internal Applicants Only
- Duration
- Open until filled
- Description
-
Let’s do great things, together!
About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Position Summary
Moda Health is seeking a Provider Correspondence Coordinator in our Medical Claims department. This position researches and provides written response to medical provider correspondence and appeals regarding claim edits, processing, authorizations and medical necessity reviews; researches and provides written response to medical inquiries regarding benefit and plan design issues. This is a FT WFH role.
Pay Range
$19.05 - $21.43 hourly (depending on experience)
**Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.
Please fill out an application on our company page, linked below, to be considered for this position.https://j.brt.mv/jb.do?reqGK=27758650&refresh=true
Benefits:- Medical, Dental, Vision, Pharmacy, Life, & Disability
- 401K- Matching
- FSA
- Employee Assistance Program
- PTO and Company Paid Holidays
Required Skills, Experience & Education:- Responds to provider appeals and related correspondence.
- Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes.
- Performs a total claim review to determine over/underpayment on problem claims.
- Works with Claims Support to adjust previously processed claims.
- Documents accurately in Facets regarding outcome of claims disputes.
- Meets the departments established standards for case completion.
- Other duties as assigned.
Primary Functions:
- Responds to provider appeals and related correspondence.
- Interacts with physician/provider offices by letter or phone to gather additional information regarding claim disputes.
- Performs a total claim review to determine over/underpayment on problem claims.
- Works with Claims Support to adjust previously processed claims.
- Documents accurately in Facets regarding outcome of claims disputes.
- Meets the departments established standards for case completion.
- Other duties as assigned.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.
For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.#INTONLY
