FHAS is seeking full-time Healthcare Dispute Specialist for its federal healthcare dispute team. The federal dispute resolution process is the newest and most innovative change to healthcare disputes in the United States. FHAS is one of only a few companies across the United States certified as an Independent Dispute Resolution Entity (IDRE). FHAS needs smart, committed Specialists, who can excel in a fast-paced environment. Specialists must be able to deliver with minimal supervision, identify deficiencies, be a self-starter, adapt to changes, take the lead when needed, and be an excellent communicator. This is an on-site position located in Plymouth, PA. Local applicants only.
Specialist duties:
- Reviews, analyzes, and processes appeals.
- Utilizes guidelines and review tools to analyze appeal information in preparation for review and determination.
- Upon receipt of determination, specialist will route the file to quality assurance for review.
- Once quality has approved, specialist will ensure proper steps are followed to close out the appeal.
- High level interpreting, analyzing, and entering information into databases/applications.
- Offer opinions and suggestions regarding operational workflows and processes based upon personal experience and performance of job duties.
Experience and skills:
- Coding or medical terminology knowledge preferred
- Insurance/Billing Specialist: 2 years (Preferred)
- Denials and Appeals: 2 years (Preferred)
- Experience in spreadsheets, workflow processes, and working in a fast-paced environment with an operational team.
- Computer skills, including proficiency in word processing, email communication, transferring, copying and pasting of data, and use of Microsoft Office
- Action-oriented, entrepreneurial, flexible, and innovative approach to operational workflows
- Strong verbal communication skills, attention to detail, and critical thinking.
- Be a team player
- Effective interpersonal skills
- Use independent decision-making skills to determine eligibility of potential claims
- Meet or exceed expectations in quality audits
Education:
- High school or equivalent (Required)
- Bachelor’s Degree (Preferred)
EEO STATEMENT FHAS is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status.
Job Type: Full-time
Job Type: Full-time
Expected hours: 40 per week
Benefits:
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- Monday to Friday
Application Question(s):
- EEO-1 Voluntary Self Identification Form
Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by the Human Resources department. Submissions can be included with resume to resumes@fhas.com
If you choose not to self-identify your race/ethnicity at this time, the federal government requires FHAS to determine this information by visual survey and/or other available information.
GENDER
(Please indicate ‘Male’, ‘Female’, or ‘I do not wish to disclose’)
Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by the Human Resources department. Please return completed forms to the HR department.
RACE/ETHNICITY
(Please indicate ‘Hispanic or Latino’, ‘White’, ‘Black or African American’, ‘Native Hawaiian or Pacific Islander’, ‘Asian’, ‘Native American or Alaska Native’, ‘Two or more races’, or ‘I do not wish to disclose’)
VETERAN STATUS
(Please indicate ‘Yes, I am a protected Veteran’, ‘No, I am not a protected Veteran’, or ‘I do not wish to disclose’)