PPO Repricer I - HNAS

CompanyHighmark Inc.Job DescriptionHNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve.This role is based in Blue Bell, PA - the role will work from home the majority of the time however this role will also be the backup for the mail room as well and will need to go onsite to the Blue Bell office during that time.DutiesProcess PPO workload assigned. Maintain production and quality standards. Monitor workflow reports to insure backlog is current and jobs are appropriately prioritized. Maintain knowledge of standard operating procedures. (60%)Provide excellent communication and service with membership, clients, PPOs, management, peers and other areas within the organization. Work with external PPOs and claims staff to resolve PPO repricing issues. (40%)Perform other duties as assigned.Education/Experience/Skills RequirementsRequired Education: HS/GEDRequired Experience: Knowledge of claims terminology is preferred.Required Knowledge/Skills:Knowledge of insurance or claims terminology and ability to work in a fast paced production environmentExcellent communication skills both verbal and writtenOrganizational skills and detail orientedComputer experienceExcellent decision and judgment skillsAbility to work independently and with the teamRequired Licenses/Certifications: Problem SolvingAbility to research and seek assistance through resources provided to insure resolution on repricing issues or correspondence is completed. Must be able to multi-task and follow-up at appropriate intervals. Raise concern with management on workload or issues in a timely manner.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org