- You will assist in providing cost savings to the Client by researching and updating other health insurance plans. This is accomplished by verifying plan information via calls to insurance carriers or by utilizing online verification portals.
- You will respond to requests from the Client, State agencies, Federal agencies, providers, members, and representatives within the Company.
- You will research and work claims that require research for reasons relating to other insurances.
- You will assist in claims auditing to ensure that providers have properly billed third party payers.
- You will work with a team to ensure that all daily work is performed within service level agreements.
- Manage independently workload with minimal supervision.
- Multi-task various work duties.
- Compose professional responses to inquiries.
- Cross train against different functions on the TPL team.
- Quickly and accurately enter data into spreadsheets, documents, and the State system.
- Working and training remotely, with minimal supervision after the training period.
- Learning the various commercial plan types, and how to verify them with insurance carriers.
- A steady, fast paced workload that often requires switching tasks as the workflow progresses.
- A shift of Monday through Friday, 8:30 to 5:00 PM with a half hour lunch.
Third Party Liability Analyst - Any city, United States - Gainwell Technologies LLC
Description
Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The Third-Party Liability (TPL) department's primary function is to pursue and investigate cost avoidance and cost recovery opportunities. The TPL analyst will review leads provided by various resources to make a determination on members' access to primary insurance coverage which would be used prior to their Kansas Medical Assistance Program (KMAP) coverage. The TPL analyst will also review applications for the Health Insurance Premium Payment (HIPP) program, facilitate the monthly Desktop Review audit and process medical subrogation leads. Work assignments include claim research, reports, legal documentation reviews, and corresponding with carriers, vendors, employers, and the State client. The Third-Party Liability (TPL) department's primary function is to pursue and investigate cost avoidance and cost recovery opportunities. The TPL analyst will review leads provided by various resources to make a determination on members' access to primary insurance coverage which would be used prior to their Kansas Medical Assistance Program (KMAP) coverage. The TPL analyst will also review applications for the Health Insurance Premium Payment (HIPP) program, facilitate the monthly Desktop Review audit and process medical subrogation leads. Work assignments include claim research, reports, legal documentation reviews, and corresponding with carriers, vendors, employers, and the State client.
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The pay range for this position is $30, $43,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.