Associate, Claims Support Services

at  MVP Health Care

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
Full-Time, Non-Exempt
At MVP Health Care, we’re on a mission to create a healthier future for everyone – which requires innovative thinking and continuous improvement. To achieve this, we’re looking for an Associate, Claims Support Services to join #TeamMVP. If you have a passion for Data driven decision making, Being Curious, and Research and problem solving, this is the opportunity for you.

QUALIFICATIONS YOU’LL BRING:

• A High School Diploma required. Associates in Health, Business or related field preferred. Relevant work experience may be substituted for degree or equivalent combination of education and related experience
• Previous medical claims processing experience required. Knowledge of CPT, HCPCS, ICD-9-CM coding systems and medical terminology.
• The availability to work full-time, Virtual in New York State
• Curiosity to foster innovation and pave the way for growth
• Humility to play as a team
• Commitment to being the difference for our customers in every interaction
• Strong Verbal and Written Communications
• Critical Thinking and Problem Solving
• Adaptability
• Strong Time Management
• Ability to sit at a computer for an extended period of time.

• Ensuring great member and provider experience by accurately and efficiently processing claims adjustments, while concentrating on putting our customers at the center of how Operations operates.
• Ensures accurate and timely processing of claim adjustments/service forms and ad-hoc projects/retro database items in accordance with medical and ancillary guidelines and benefits.
• Acts as a liaison with other department and outside vendors to resolve claim issues as they arise while also conducting root cause analysis on those issues with a focus on improving the member and provider experience.
• Completes daily reports as needed with flexibility to move from one project to another on a daily/weekly basis.
• Evaluates all business processes to proactively identify efficiency opportunities and partners with team leads to implement production and quality standards, identify trends and recognize process improvements with a focus on continuous improvement.
• Will work to reduce the number of complaints, appeals and DFS issues along with improvement in the average turnaround time and reduction in the number of hand-offs within the organization
• Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.