Who we are: Third Way Health ( helps medical practices and healthcare organizations across the United States to improve the patient experience while reducing the administrative burden on practice owners and management. We enable practices and healthcare organizations to enhance the experience of their patients by providing them with a leading technology platform and world class services. What unites us is our passion to support physicians and help patients from all backgrounds to have a better healthcare experience.
About the position: We are seeking a full-time Denial Coordinator to join our team in the Medellin area. As a valued member of our team, you'll play a crucial role in enhancing the healthcare experience for thousands of patients and providers in the US. In this role, you will review and process daily assigned deferrals or denials (this includes modifications, carve out, and resolution). Ensure daily monitoring of denial inquiries, comply with internal policies and procedures, and perform any other tasks as requested. Weekend and holiday coverage may also be required based on business needs.
Responsibilities: Assess and process daily assigned deferrals and denials, including decisions to deny, modify, or carve out cases. Review daily failed fax reports related to denials and deferrals. Ensure that letters and notifications are refaxed and properly documented in the referral system Monitor denial inquiries daily, refax denial notifications or letters as needed, and respond to provider or interdepartmental emails. Document all communications in referral notes Offer phone support for manual processes, addressing any issues or questions that may arise during operations. Follow internal policies and procedures diligently to maintain operational efficiency and uphold quality standards within the team. Undertake any other job-related responsibilities as assigned to support team objectives and contribute to overall operational success Accurately log cases in software platforms to track and manage healthcare processes, AYCE and EZCAP, as necessary to ensure effective case handling and documentation. Required skills and qualifications: University or associate degree Required knowledge in health insurance (at least 8 months) Strong communication, both written and verbal (candidates must be fluent in English and Spanish, C1 or above preferred) Expertise in healthcare (US healthcare sector experience; does not need to be a nurse or doctor) and managing call center operations Great active listening skills A patient and empathetic attitude Strong time management and organizational skills Adaptability and flexibility Comfortable working in fast-paced environments Excellent troubleshooting skills Computer literacy and proven track record of working in multiple systems in parallel Phone skills, including familiarity with complex or multi-line phone systems #J-18808-Ljbffr