Billing and Claims Associate
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Job Description
Billing and Claims Associate role at Talkspace addressing client inquiries. Educating clients on billing procedures and resolving escalated issues with empathy.
Responsibilities:
- Use internal knowledge materials + resources to educate Talkspace clients on our billing and claims procedures, and quickly and accurately respond to escalated service-related billing inquiries from existing members, including but not limited to questions related to enrollment errors, refund requests, claims adjustments, superbill requests, etc.
- Resolve complex and/or escalated inquiries that require investigation and a high degree of empathy, ensuring every interaction with Talkspace leaves our clients feeling cared for, understood and supported.
- Participate in non-inbound volume related department operations speciality projects aimed to further support our clients in their full journey at Talkspace, ie.
- Charge disputes
- Medical records request for billing records
- Billing affidavits (written and verbal)
- Conduct outbound calls to payors, obtain member EAP authorization, and discuss claim submissions on a case by case basis.
- Draft and provide superbills to clients when requested, as needed.
- Serve as company claims SME and collaborate with internal stakeholders on billing and claims-related ad hoc projects, as assigned.
- Work closely with our Client Support team, providing status updates on known payer issues and assisting with client escalations, as needed.
- Provide white glove service to all our members, infusing empathy and kindness in all replies, and following up with clients when necessary to ensure resolution.
- Keep up with business updates to ensure the assistance provided is accurate and up to date.
- Identify client contact reason trends and roll up any potential issues affecting a specific segment of clients to leadership daily, as needed.
- Contribute to the improvement of our department by suggesting updates to departmental knowledge materials + resources (internal knowledge base, correspondence templates).
- Recommend changes to existing support processes and/or implementation of new standard processes aimed at improving productivity, job satisfaction, and our client experience.
- Serve as onboarding buddy to department new hires and participate in onboarding training as SME, as needed.
- Attend all department meetings (ie. coaching sessions, recurring 1:1s, ongoing training lessons), as scheduled.
- Maintain regular communication with your Supervisor and team, daily.
- Performs other related duties as assigned.
Requirements:
- 2+ years experience with health insurance claims or support environment, required; preferably in a phone/email/chat support-related capacity.
- Knowledge of Behavioral Health terminology (ie CPT Codes) and understanding of Insurance benefits ( ie: copy, coins and deductible), required.
- Knowledge of and ability to comply with PHI and HIPAA guidelines when working with sensitive material, required.
- Experience in the tele-health, tele-therapy, medical insurance industries is a plus.
- Familiarity working within payor portals, third party healthcare clearinghouses, required; Zendesk, Atlassian (Jira, Confluence) is a plus.
- High School diploma or equivalent preferred.
- A 4-year college degree is a plus.
- Excellent written and verbal communication skills.
- Highly organized and detail-oriented.
- Passionate about providing top-tier support.
- Ability to work independently, as this is a remote team, and maintain consistent communication with Supervisor.
- Ability to meet productivity and quality benchmarks set by leadership.
- Ability to multi-task in various systems + programs.
- Experience (or strong interest) in working in a fast-paced, rapidly changing environment.
- Dependable internet connection required.
- ~50-60 wpm - https://www.typingpal.com/en/
Benefits:
- Comprehensive Medical, Dental and Vision plans coverage since day one
- Pre-tax benefits: HSA/ FSA
- 401k Retirement Savings Program with matching up to 4%
- Voluntary benefits including disability, basic life or pet insurance, etc.
- Monthly Wellness Stipend to promote mental and physical self-care
- Flexible PTO and Remote First Environment
- Regular team events, including Wellness Workshops and Team Building Events
- Free access to Talkspace products for you and one household member, as well as access to a friends and family discount!
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