MVP Health Care Associate, Senior Dental & FSA Services in Schenectady, Rochester, Syracuse, New York
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.
Provides assistance to Supervisor and helps monitor daily activities of the team. Acts as content expert and handles any workflow issues related to customer care center or claims processing in the Supervisors absence. Back up for Supervisor when unavailable or on PTO. Familiar with claims processing standards to meet Regulatory Compliance Requirements. Familiar with Customer Care metrics for ASA, Abandon Rate and Service Level. Responsible for training new hires and mentoring seasoned employees if needed. Acts as liaison to question from internal departments. Senior will provide feedback to supervisor concerning daily activities or, issues in department. Ensures teamwork workload is running effectively. Review’s quality control appeals and assists examiners in dispute process if necessary. Maintains Departmental Email Inbox. Manages Manual Eligibility Reports. Assist Customer Care Center when appropriate. Process member/provider refund checks. Send and track overpayment letters. Liaison between QA dept and examiners, distribute audit errors, track responses, appeals and return to the QA department timely. Assists supervisor with identifying training, process improvement, and procedure clarification to meet and/or exceed quality and productivity goals and Call Center goals. Other duties as assigned.
Minimum Education: 2 year college degree or directly related business experience.
Minimum Experience: One year claims experience. Customer service experience preferred.
• Strong verbal and writing skills required.
• Ability to work independently as well as with team.
• Strong organizational skills, attention to detail, ability to multi-task efficiently and effectively.
· Takes initiative
• Maintain HIPAA compliance
• Analytical thinking
MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at firstname.lastname@example.org.