Claims Specialist (Remote)

Now is the time to join us!

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

Who are you?

As a Claims Specialist, you will complete claim processing tasks and duties while performing best practices in time management, inventory, quality and procedures.

In this role you will wear many hats, but your knowledge will be essential in the following:

• Maintain quality and procedure standards including compete review and examination of claim to ensure proper handling in accordance with company policies and procedures.
• Complete claims task in timely manner and maintain production requirement:
• Review and understand plans, documents and vendors. Ensure proper system setup while processing claims. Identify and report to management any potential errors, problems or issues regarding plan documents, claims processing or system setup.
• Work stop loss renewal process, as directed by management.
• Complete all training requirements in a timely manner, as directed by management.
• Understand and enforce company procedures, polices and standards.
• Practice good follow up procedures to ensure completion of task and/or inquiries.
• Direct client contact, internal staff and vendor support to ensure customer and member satisfaction.
• Support management team with projects and special request

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

What you bring to the Personify Health team:

In Order To Represent The Best Of What We Have To Offer You Come To Us With a Multitude Of Positive Attributes Including

• High School Diploma required
• 2 years claims processing required.
• Associate’s degree in business preferred
• 5+ years claims processing in the QicLink system preferred.

You also take pride in offering the following Core Skills, Competencies, and Characteristics:

• Must be able to establish and maintain good working relationship with clients and provide excellent customer service
• Must be computer literate and knowledgeable in Windows and Microsoft Office environment, including Word, Outlook and Excel. Knowledge of insurance database system a plus.
• Ability to work with others to accomplish mutual goals
• Healthcare industry experience strongly preferred, specifically in healthcare, health insurance, medical office or clinical experience at a front desk, in billing or admissions
• Remote work is possible depending on experience and business needs

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $15.00 to $21.00. Note that compensation may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

#WeAreHiring #PersonifyHealth

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@ personifyhealth .com . All of our legitimate openings can be found on the Personify Health Career Site .

Application Deadline: Open until position is filled.