Job Information
AmeriHealth Caritas Services LLC Check Research Specialist in Philadelphia, Pennsylvania
If interested in this position email Lauren Swartz at lswartz@pacareerlinkphl.org and click "apply". Job postings at this company open and close quickly so send Lauren an email ASAP.
For qualified candidates, Lauren will provide the company's career website to apply, and will follow up with her company contact on your behalf.
Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
Under the general direction of the Provider Check Unit Supervisor, the Check Research Specialist is responsible for the daily processing/adjusting of claims related to the provider and plan checks received for all lines of business within AmeriHealth Caritas Family of Companies, including Medicaid and Medicare. They are responsible for completing research analysis, claims application, and/or correction of all provider and non-address related plan checks returned by all Lines of Business. They are also responsible for handling complex documents received from providers and contacting providers by phone, fax, or mail to provide follow-up in a timely manner.
Education/Experience:
- Minimum of 3 years in Claims Processing using Facets and EXP
- CORS experience is a plus
- High School/GED required
- Healthcare, HMP, or Medical Assistance experience
- Proficient in Microsoft Office applications
Diversity, Equity, and Inclusion
At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Phila BST