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Provider Claims Liaison

Company Name:
ValueOptions, Inc., a Beacon Health Options company
ValueOptions, Inc., a Beacon Health Options company
Provider Claims Liaison
ValueOptions is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled.
Position Location: NJ - Roseland
AAP Reporting Location: NJ - Roseland
ID: 32176
Job Family: Customer Service
Functional Area: CUSTOMER SERVICE
FTE Status: Full time
Scheduled Weekly Work Hrs: 40
Workday Schedule: Weekdays Only
Workday Start Time: 8:00am
Workday End Time: 5:00pm
Variable Work Schedule:
ABOUT OUR COMPANY
ValueOptions is a health improvement company that serves more than 32 million individuals. On behalf of employers, health plans and government agencies, we manage innovative programs and solutions that directly address the challenges our health care system faces today. A national leader in the fields of mental and emotional wellbeing, recovery and resilience, employee assistance, and wellness, ValueOptions helps people make the difficult life changes needed to be healthier and more productive. With offices nationwide and a network of more than 130,000 provider locations, ValueOptions helps people take important steps in the right direction. We help them live their lives to the fullest potential.
ABOUT OUR PEOPLE
At ValueOptions, it's more than a job. Our employees embrace the company vision of helping people lead healthier lives. The over 3,100 employees on our team enjoy challenging career growth in an environment that values integrity, innovation, consumer engagement and joint accountability. Employees have access to comprehensive benefit packages; corporate discounts; continuing education opportunities, including our online learning portal, and more. At ValueOptions we strive to build a boundless culture and community of professionals that includes honest, open and free-flowing communication. We are passionate about the work we do.
If you have a passion to make a difference and a thirst to actively develop your knowledge and skills, join the ValueOptions team!
ABOUT THE POSITION
We are currently seeking a dynamic Provider Claims Liaison to join our team at our office in Roseland, NJ. The Provider Claims Liaison will be responsible for coordinating responses to complex claims issues.
Position Responsibilities:
1. Manage the receipt, investigation and resolution of escalated issues in a timely and highly effective manner.
2. Lead and support the research, analysis and resolution of account and/or provider claim projects.
3. Participate in site visits as required to assess and facilitate claim related issue resolution.
4. Promote a positive interface to problem resolution with suggested process improvement opportunities between Horizon Behavioral Health Customer Service, other ValueOptions departments, and Horizon.
5. Serve as a key resource as related to Horizon Behavioral Health Customer Service functions/transactions.
6. Support Horizon Behavioral Health Customer Service as business needs demand.
7. Complete projects and other research tasks as assigned by management.
8. Comply with all HIPAA Compliance regulations
Position Requirements:
Education : An Associate's Degree or equivalent work experience is required.
Licensure : N/A.
Relevant Work Experience: 1-2 years' experience in health care/health insurance/managed care with excellent knowledge claims and customer service function is required. Excellent verbal and written communication skills, exceptional time management and interpersonal skills are also
PI91553691

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