AmeriHealth Caritas Check Research Specialist in Philadelphia, Pennsylvania

Check Research Specialist


Description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Under the direct supervision of the Supervisor and Manager of the Cost Containment Analysis, responsible for handling research analysis, application and correction of all provider and non-address related plan checks returned by all Lines of Business. Responsibilities include handling more complex documents received by providers, including contacting providers by phone, fax or mail to appropriate follow-up in a timely manner.

Education/Experience:

  • High School/GED.
  • 3-5 years' in Claims Processing using Facets, healthcare experience, HMP or Medical Assistance.
  • Proficient in Microsoft Office Products; some college coursework preferred.