Be a great Accolade Health Assistant, and in particular a role model for other AHAs in resolving claims and benefits issues for and with clients.
Act as trusted source of complex claims and benefit questions for internal customers
Act as liaison to health plans and providers to solve complex claims and coverage issues and get claims
processing/payment issues corrected.
Educate AHAs in helping them better understand claims and benefit question resolution, both in helping with specific
client issues and in new hire and ongoing training.
Identify opportunities to improve how we resolve claims and benefit issues, including improvements to MRM, workboxes,
our benefits, and other tools and resources.
Collaborate with Accolade team mates to deliver best possible service experience for Accolade clients.
Collaborate with health plans and providers to deliver best possible service experience for our clients and encourage
future collaboration with health plans and providers.
Effectively manage an ongoing portfolio of claims/benefits issues, ensuring timely, complete and accurate resolution in support of client expectations and health plan processing guidelines.
Able to do all of the above in a collaborative, open-office, telephonic, technology enabled environment
Desired Qualifications and Experience
A thorough understanding of health care delivery and previous experience with medical benefits (primarily self-insured plans) and claims from either provider or payor perspective.
Examples of prior job experience/expertise:
Health Plan or third party payor claims processing experience with strong technical skills (business expertise) and knowledge of various lines of business and applicable coding (CPT, HCPCS, ICD-9/10, DRG, etc.)
Health Plan business/benefit analyst with an emphasis on claims coding (see above line) and benefit set-up
Health Plan claims quality assurance
Practice Management or Hospital –Familiar with all bill types and national account billing
Engage others by being a good listener with a solid capacity for empathy.
Possess excellent communication skills and the ability to convey passion and enthusiasm.
Possess superior ingenuity, judgment and problem solving skills.
Partner/work with teammates to solve issues for clients.
Organized, dependable and meticulous.
Flexible with a high tolerance for ambiguity.
The ability for self-reflection and the capacity to accept and implement feedback.
Must be computer literate at an intermediate or advanced level.
Must display honesty and integrity.
Must be comfortable working in a telephonic environment with clients, health plans, and providers.
Accolade offers the country’s leading consumer healthcare engagement and influence solution for large self-insured employers and payer organizations. Our single, integrated solution combines the power of technology with 1:1 human interactions to help people get the right care and have a better healthcare experience.
By addressing some of the biggest problems facing healthcare – system complexity, low consumer engagement and lack of trust – we’re able to reduce avoidable consumer errors and the estimated 30-40% of waste in the system caused by unnecessary or unproductive care.
The way we make healthcare simpler and less costly is to give individuals and families access to their own professional Accolade Health Assistant®. Our health assistants are a single point of contact for any health benefit or healthcare-related need. By taking the time to get to know their clients as individuals and understanding the contextual issues surrounding their decisions, health assistants are able to develop trust-based relationships, which lead to greater influence over care decisions, better health outcomes and greater savings. At the same time, we’re delighting the families we serve, earning world-class Net Promoter Scores and near-perfect client satisfaction ratings.
Founded in 2007 and headquartered in Plymouth Meeting, Pa., Accolade has nearly 600 employees serving the individuals and families of some of the nation’s largest businesses. We’ve been recognized as one of the nation’s 25 most promising companies by Forbes magazine, the fastest-growing private healthcare company by Inc. 500, and a Top Workplace in Philadelphia for five consecutive years. For more information, visit www.accolade.com.