Job Description

Who are we?

Welltel

is a privately owned, rapidly growing telehealth company operating in New York. We have a profound dedication to nurturing our patients, embodying a commitment to compassionate healthcare. We offer a double dose of care, delivering virtual healthcare services with a personalized touch.

Why join us?

We are guided by a steadfast mission to provide comprehensive and culturally sensitive care to every individual we serve. We care not just about our patients but also about our employees. As a rapidly growing company, there is always a scope to elevate your career with us!

What are we looking for?

We are looking for an experienced

Insurance Specialist

, who will be the subject matter expert, accountable for achieving the required business results through effective process, workflow, and quality management.

The primary focus of the Insurance Specialist will be to ensure that all insurance policies and claims are processed accurately and efficiently. The role of an Insurance Specialist is crucial in managing and overseeing the operations of an insurance department. This includes ensuring compliance with regulations, resolving customer issues, and driving efficiency and productivity.

The ideal candidate for this position should possess strong communication skills, as well as a deep understanding of insurance policies and procedures. The successful candidate will optimize departmental performance, maintain high levels of customer satisfaction, and contribute to the overall success of the team.

This is a full-time, remote position with a pay rate of $5-$8 per hour. The schedule is Monday through Friday, 9 am to 5 pm EST

Key Responsibilities:

Oversee the day-to-day operations of the insurance department, ensuring work is completed accurately and within established timelines. Develop and implement departmental policies, procedures, and workflows to enhance efficiency and streamline operations. Ensure compliance with industry regulations, company policies, and ethical practices, while handling insurance claims and policy issuance. Monitor and review insurance claims to ensure prompt and accurate settlement, resolving any disputes or issues that arise. Collaborate with other departments and stakeholders to integrate insurance processes and requirements into the overall business operations. Stay updated on industry trends, emerging technologies, and changes in regulations to provide guidance and ensure compliance. Create and maintain reports, metrics, and performance indicators to assess departmental performance and identify areas for improvement. Handle escalated customer inquiries or complaints, providing excellent customer service and ensuring prompt resolution. Ensure the highest level of customer service and facilitate all actions necessary including research and follow up to positively satisfy customer needs. This includes building and forging strong relationships with field partners and internal customers.

Key Qualifications

Bachelor's degree in business, finance, or a related field. Must have proven experience in handling

NY Medicaid and Medicare insurance

, including claims processing, billing, and compliance with regulations. Preferred someone with heavy experience with

NY insurances

. Proven experience in the

insurance industry

, with at least 3-5 years of experience in insurance claims, policy issuance, or underwriting. Excellent knowledge of insurance principles, policies, and practices. Proven experience in handling

Medicaid and Medicare

insurance, including claims processing, billing, and compliance with regulations. Knowledge of

insurance codes

, including ICD-10, CPT, and HCPCS, and experience applying them for accurate billing and coding. Proficient in insurance claims processing and policy issuance. Familiarity with insurance software and tools, such as policy management systems and claims processing platforms. Solid understanding of industry regulations and compliance requirements. Customer-focused mindset with a commitment to providing excellent service. Ability to work under pressure and handle multiple tasks simultaneously. Strong understanding of insurance regulations, compliance, and ethical practices.

Key Skills

Excellent verbal and written communication skills, with the ability to effectively communicate complex information to different stakeholders. Exceptional interpersonal skills, with the ability to build relationships with internal and external stakeholders. Professional demeanor and a strong commitment to maintaining confidentiality. Well-developed problem solving, analytical and decision-making skills, including the ability to analyze situations, diagnose problems, develop and implement solutions, often within narrow timeframes, e.g. preventing complaints from escalating further and turning potentially damaging caller situations into positive caller experiences. Further includes being able to facilitate creative problem solving with others. Also includes being a forward thinker. Exceptional organizational and time management skills, with the ability to prioritize and meet deadlines.
Job Type: Full-time

Pay: ?427.04 - ?683.26 per hour

Expected hours: 40 per week

Schedule:

Monday to Friday
Work Location: Remote