Become part of our family.
Are you a friendly, high-energy person who enjoys being part of a team? Be part of ours! We're hiring motivated, personable individuals dedicated to providing efficient, compassionate service to our clients. Point Comfort Underwriters® (PCU) is a woman-owned company in Indianapolis, Indiana dedicated to diversity, inclusiveness and to the idea that work can be fun if you approach it with the right attitude and surround yourself with excellent people.
PCU is a fast-growing international healthcare administration and travel medical insurance underwriter. Founded by industry veterans in 2014, PCU provides travel health insurance plans, healthcare access and claims management services to non-US citizens living in the US, and US citizens traveling abroad in over 120 countries worldwide. We're dog-friendly, and invested in employee wellness. We're not a huge, faceless corporation. In fact, while still upholding high standards of professionalism, there is definitely a bit of a family vibe at Point Comfort ...and we like it that way. Sound like something you'd like, too? Consider joining our family!
If you have any additional questions or would like to submit a resume please email: firstname.lastname@example.org
Current Opportunities at PCU
Point Comfort hires people, not resumes. Don't get discouraged if your specific experience doesn't line up exactly with a particular job listing,* we can train you! If you're energetic, intelligent, personable, hardworking and dependable, there's likely a place for you here.
*A notable exception: any of our positions that requires a license (e.g. a licensed nurse for our Clinical Services department).
(LPN) Medical Pre-Authorization Specialist
- Preauthorization of healthcare and medical service events
- Resolution of healthcare delivery & medical expense issues, and all other questions.
- Telephone, email, and fax communication with customers seeking access to health services, answers to benefits questions, procedures, and general customer service
- Strong knowledge of medical coding and healthcare terminology required.
- Emergency and non-emergency preauthorization experience.
- Knowledge of claims processing, diagnosis codes and prior interaction with healthcare providers, billing protocols.
- Medicare and Medicaid billing experience.
- Pediatric and adult patient care knowledge.
- Ability to multi-task and work independently using critical thinking skills
- Typing skills and working knowledge of MS Office applications required.
- Excellent verbal and written skills
- Positive personality traits, team-oriented work ethic, and a great customer service attitude.
Provider Contracting Specialist
- Maintains and expands the health care delivery system network by negotiating contracts and maintaining relationships with providers
- Execute single case letters of agreements for members referred to out of network providers to ensure access to care in a timely and efficient manner
- Collaborates closely with Client Relations, Claims, and Clinical Teams
- Works collaboratively with the provider consultants and representatives to ensure that contracts are appropriately administered.
- Accountable for ongoing management of executed agreements including assessment and resolution of issues, contract performance monitoring unit-cost budgeting, and ongoing provider engagement
- Assist in managing email inquiries from external users (i.e. providers, clients, and members).
- Support those who direct and implement strategies relating to the development & management of the provider network.
- Ensure that all provider information and reimbursement information is accurately communicated in company database to ensure proper claims adjudication.
- Collaborate closely with Client Relations, Claims, and Clinical Teams
- Act as a liaison and resource to network providers during all phases of the contracting process.
- Assists with training of new employees.
- Minimum Associate Degree preferred in business, healthcare policy, public health, or related field
- Requires at least 2-3 years provider contracting / negotiation/ provider relations experience including experience managing complex negotiation
- Strong analytical and problem-solving skills and ability to express ideas clearly in both written and oral communications
- MS applications and Excel
Provider Relations Specialist
- Initiate provider outreach for Provider Contract Specialists based upon leads or requests from program participants
- Facilitate single case and non-complex agreements as needed
- Research care gaps and perform outreach initiatives
- Update provider profiles and fee schedules as needed
- Initiate / investigate resolution of escalated issues received by phone / fax / email that include claims payment and contracting concerns
- Ensure that all provider information and reimbursement information is accurately communicated to our company database to ensure proper claims adjudication.
- Accountable for provider satisfaction, service, and retention for assigned providers
- Assist in efforts to enhance ease of use of provider portal and future services enhancements
- Other administrative duties as assigned
- 2-5 years’ experience in healthcare / insurance industry
- Intermediate level of proficiency in claims processing and issue resolution preferred
- Experience with provider relations and/or provider network experience
- Experience with health care/managed care experience
- Experience with Medicare and Medicaid regulations
- Familiarity with Mac and PC computer applications, including the ability to learn new and complex computer system applications
- Excellent typing skills and working knowledge of Mac, PC and MS Office applications required
- Knowledge of claims processing, medical and healthcare terminology a real plus
- Investigate, research, and resolve medical claims and service issues presented by clients or provider, by navigating multiple computer systems.
- Communicate and collaborate with clients to resolve billing/medical claims issues using clear, simple language.
- Build professional relationships with providers and billers
- Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, and client satisfaction.
- Assist with completing provider network requests for insurance plans
- Ensure that received balance bills from providers are resolved
- Navigate databases related to provider billing and insured benefits and eligibility
- Maintain professional written, verbal, and electronic communication
- Other duties as assigned and necessary to fulfil departmental projects or needs.
- Combination of at least 2 years of education (in a related field) or work experience in related field of providers, health insurance, medical billing or claims).
- Candidates must be able to communicate clearly and professionally.
- Ability to multi-task.
- Excellent typing skills and working knowledge of PC and MS Office and Excel applications
- Knowledge of medical and healthcare terminology.
- Ability to multi-task, as well as the ability to understand and communicate details regarding multiple products and levels of insurance benefits within each product
Company benefits include:
- Personal time off and paid holidays
- Medical insurance and AD&D Life Insurance Policy paid by employer
- Generous 401(k) plan with a company profit sharing and vesting program
- Tuition Benefit
- YMCA corporate membership
To apply to any of the above jobs, head to our Jobs page on Indeed.com by clicking here.