• You will be responsible for the timely intake and processing of all incoming cases as well as Guarantee of Payments.
• The Guarantee of Payment is a confirmation towards the hospital regarding length of admission, treatment, and insured amount
• Analyze requests for hospitalization and evaluating treatments, as well as amount and the length of stay depending on policy
• Act as liaison between medical providers and insured individual, mainly by phone, to obtain all necessary information
• Review and monitor cases to ensure files are cascaded to appropriate teams, depending on specific identified triggers
• Act as point of contact for hospitals regarding all questions related to the Guarantee of Payment
• Negotiate discounts with providers
• Maintain all necessary information regarding the hospitalizations in an internal database
• Translate and interpret medical and other relevant documents for case analysis
• Work independently and effectively to communicate to internal and external customers by telephone and e-mail
• Maintain accurate workflow and process documentation following outlined processes

Requirements

Qualifications

• Diploma or Bachelors degree required
• 1-2 years of experience in a customer service or claims environment
• Experience in healthcare operations background preferred
• Ability to speak, write and read English, any other language a plus
• Business Application: Ability to initiate research, plan and coordinate
• Proven ability to build relationships with matrix partners
• Ability to work and problem solve independently but escalate when needed
• Convey information clearly to both medical providers, internal partners, and customers
• Medical Terminology Background
• Must be comfortable to work permanently on night shift (working from home).

Competencies

• Customer-focused: works efficiently with internal partners to find best solutions for customers
• Skilled decision-maker: takes the right action on dedicated files based on available  information
• Accuracy: ensures concise and correct information is being delivered
• Disciplined: follows procedures, agreements and document flows correctly.
• Efficiency: able to strike the right balance between quality and quantity
• Team-player: enjoys working as part of a team and building internal networks
• Computer-literate: quick to learn International in-house systems and use current office applications