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TPC Resolution Specialist
Job ID R26738
Date posted 05/17/2022
Title: TPC Resolution Specialist
Overview of Position
This position is responsible for the claims’ resolution portion of Change Healthcare’s Third Party Coverage Advocate Solution for Motor Vehicle Accidents (MVA), Workers’ Compensation, and other liability accounts. The Third Party Coverage Advocate Resolution Specialist will be responsible for investigating, billing and collecting on hospital claims from Property & Casualty insurance carriers (ex: Auto Insurance, Work Comp). The CCS will communicate with patients, insurance adjusters and attorneys to resolve claims.
What will be my duties and responsibilities in this job?
- Initiate outbound calls to patients to complete accident interviews via telephone
- Investigate and confirm any medical coverage related to auto, general liability, and/or worker compensation insurance available to the patient, updating the patient file in the system
- Contact Auto/Work Comp insurance carriers and attorneys via telephone to identify available accident insurance coverage for the patient
- Verify patient’s eligibility for coverage and obtain billing contact information for the insurance adjuster and/or attorney
- Send hospital bill to no-fault, third party and workers’ compensation insurances via fax, mail and e-mail
- Follow up for with insurance carriers and attorneys for expedited resolution and payment on patient’s account
- Request documentation where applicable or payment and account status from insurance adjuster or attorney
- Identify any patient attorney representation and confirm patient representation with the attorney office, recording the attorney information in the patient file in the system
- File Hospital Liens (where applicable) and assist in settlement negotiation between the hospital and patient’s attorney/insurance adjuster
- Maintain proper account documentation in CHC’s Case Management System
- Send correspondence to patient, insurance adjusters and attorneys
- Complete account documentation and return account to the hospital once claim has been resolved
What are the requirements needed for this position?
- High School Diploma or equivalent
- Bachelors degree preferred
- Minimum of one year revenue cycle (ex: insurance billing, collections) experience
- Property and Casualty (Auto Insurance, Workers’ Compensation) experience preferred
- Health Insurance Appeals experience preferred
- Subrogation and Coordination of Benefits experience preferred
- Epic experience preferred
What other skills/experience would be helpful to have?
- Strong communication skills
- Excellent customer service skills
- Ability to work collaboratively with a team
- Ability to communicate effectively with patients, hospital staff, adjusters and attorneys
- General knowledge of commercial health, Medicare, Medicaid, Auto, Work Comp Insurance
- Assertive and proactive attitude towards claims resolution
What are the working conditions and physical requirements of this job?
- Office Environment
- Physical requirements include general office demands
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
COVID Vaccination Requirements
We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.
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Talent Acquisition Process
Once you apply for a job opening, the Sourcing Specialist or Talent Advisor will review your resume ensuring your background matches the minimum job requirements. Selected candidates will be invited for a phone screen.
Steps will vary by team, but typically include: Talent Advisor phone screen, hiring manager interview, and a combination of technical screens and panel interviews.
If you're selected, you can expect the Talent Advisor to reach out with specific offer details. During this stage you will be provided with an electronic offer letter and other new hire documents.
Once you've electronically signed your offer, our onboarding team will get you ready for Week 1 and set you up for success! Onboarding tasks may include a background check, drug screening, and other job specific requirements.
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