Payer Operations Coordinator
Overview
You will be responsible for ensuring appropriate insurance verification, ascertaining benefits for patients, completing pre-determinations, and prior authorizations. You will also track patient appointments and report volumes to the billing team. Additionally, you will communicate with other departments including customer service, contracting/sales, and the data team. You will be responsible for maintaining and properly handling inbound and outbound calls to payers.
Description
Key Responsibilities:
- Process and manage insurance claims, ensuring accuracy and adherence to payer requirements.
- Communicate with insurance carriers, third-party administrators, and internal teams to resolve claim discrepancies and ensure timely payments.
- Perform insurance verification and eligibility checks for patients.
- Maintain and update patient records with a high degree of accuracy and confidentiality.
- Prioritize and organize a high volume of work to meet deadlines and operational targets.
- Troubleshoot and resolve issues related to insurance processing and reimbursement.
- Collaborate with team members to improve processes and share knowledge.
- Stay current on insurance payer guidelines, regulations, and industry best practices.
Required Qualifications:
- 2-4 years of experience with insurance payer operations or similar.
- Excellent interpersonal and communication skills, with the ability to interact professionally with internal and external stakeholders.
- Strong attention to detail and ability to work with a high degree of accuracy.
- Proven trustworthiness and dedication to protecting sensitive patient information.
- Experience in a customer service or client relations role in a professional environment.
- Ability to organize and prioritize work in a fast-paced, high-throughput setting.
- Strong team player with a self-directed work ethic and proactive attitude.
- Problem-solving skills with a willingness to take initiative and learn on the job.
- Familiarity with insurance carriers or third-party administrators.
- Basic knowledge of medical terminology.
- Exemplary typing and data entry skills.
- Has graduated high school or obtained GED.
The Ideal Candidate Will Be:
- A go-getter with a “roll up your sleeves” attitude, eager to take on challenges.
- Security-minded and focused on maintaining patient privacy and data protection.
- Eager to grow with us in a fast-paced, innovative startup environment.
- Has obtained their associates and/or bachelors degree.
- Can work in the Austin office.
Work Environment:
- Team is hybrid, with a physical office in Austin, TX. Direct peers are distributed throughout the continental US. Direct Supervisor is based remotely.
Reporting Structure:
- This role will report directly to the Senior Director of Clinical Operations
Why Join Us?
- Opportunity to grow within a dynamic and mission-driven company.
- Collaborative, supportive team culture.
- Chance to make a meaningful impact on patient care and the healthcare industry.
- Flexibility in the role structure. Can be adjusted for part-time or full-time employment which would include benefits. Role structure alterations will depend on the candidate's experience.
About Us:
Happy Health is an Austin-based biotech company with $60M in venture financing and a mission to reinvent healthcare through at-home diagnostics and remote patient monitoring.
We are the personalized data layer powering AI-based healthcare. Our first product, Happy Ring (happyring.com) is the only FDA-grade biometric monitoring platform that is designed for large scale deployment, combining best-in-class 24/7 consumer wearability and clinical accuracy in the same device.
Our current focus is on clinical customers where our novel product offering has received tremendous traction. We’re helping physicians, researchers, and other healthcare professionals deliver better care to their patients in the real-world, in real-time. But clinical is just the beginning, as we explore exciting opportunities for bringing improved health into the lives of everyone through direct-to-consumer applications.
At Happy, you’ll not only make a difference quickly, having a direct effect on our success, you will also be able to grow and manage your career path. We provide access to development resources including e-learning courses, training programs, and support from our team of helpful industry experts.