Network Billing Customer Service Associate at Paradigm in Tampa, Florida

Job Description:

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

JOB TITLE: Network Billing Customer Service Associate

SUMMARY: The Network Billing Customer Service Associate is responsible for taking inbound calls and answering emails from health care providers or clients regarding claims, as well as, communicating directly with billing and finance departments for outstanding actions. Must have an outstanding attention to detail and possess a desire to succeed.

DUTIES AND RESPONSIBILITIES:

• Directly handle provider/client phone calls and emails
• Meet department standards for productivity, including number of calls handled per day/week, percentage of time spent in the queue or on calls, percentage of rejected calls, average hold and average handling times
• Review, comprehend and communicate details regarding claims status
• Document/update information in cases with high degree of accuracy
• Escalate advanced issues when appropriate
• Provide exceptional customer service to internal and external customers
• As a team member, continually support the team’s efforts to provide exceptional service by identifying ideas for improvement in documentation and/or approach.
• Complies with and adheres to all regulatory compliance areas, policies and procedures and best practices
• Understand and comply with all HIPAA & SOC2 requirements necessary in working with designated PHI
• Perform additional support functions as needed
• Responsible for complying with Paradigm IT security requirement and policies
• Responsible for safeguarding Paradigm or Paradigm related IT passwords
• Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management
• Adhering to Company policies and procedures on attendance, including requests for planned time off, reporting sickness, start time and break times.

QUALIFICATION REQUIREMENTS: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• At least 1 year of customer service experience in a medical/healthcare setting.
• Medical terminology
• Excellent communication skills both written and verbal, and internal personal skills
• Ability to work independently
• Acute attention to detail
• Proficient in all Microsoft Office and computer application systems
• Medical billing in workers compensation industry preferred but not required

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical Activities: While performing the duties of this job, the employee is regularly required to reach with hands and arms, and to talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand and walk.
• Weight Lifted/Force Exerted: The employee's job does not require weight to be lifted greater than 20 pounds.
• Vision Requirements: Specific vision abilities required by this job include close vision and the ability to adjust focus.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Environment Conditions – Office environment with office level ambient noise and conditions. While performing the duties of this job, the employee does not work in wet or humid conditions (non-weather), work near moving mechanical parts, work in high, precarious places, endure outdoor weather conditions or endure extreme cold or heat (non-weather).
• Noise Level – Will be low to moderate noise found in typical office environments.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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