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Claims Outreach Specialist

MTM Lake Saint Louis, MO
  • Posted: 3 days ago
  • Other
Consider a Career at MTM


From entry level customer service positions, to challenging technology and leadership roles, MTM offers a wealth of employment opportunities. Our corporate culture promotes healthy living, excellent work-home life balance, and strategic career advancement opportunities in a rewarding work environment where you will make a positive impact in your community and beyond. In particular, MTM is committed to providing physical activity and wellness opportunities for our employees, and we have been recognized as a Gold Level Recipient of the American Heart Associations Fit-Friendly Worksites Recognition program. As an employer, MTM offers excellent benefits and welcomes diversity; we are an affirmative action and equal opportunity employer. We invite you to apply for any of our open positions and look forward to providing you an opportunity to develop your career as a member of our team. If you can't find what you are looking for, please check out our affiliate Ride Right for more opportunities.

MTM, Inc. continues to grow and we are seeking a Claims Outreach Specialist!

MTM, Inc. is a healthcare services and transportation management company whose mission is to develop innovative solutions for accessing healthcare, increasing independence, and connecting community resources. MTM is made up of people who share a passion for making a positive impact. Our culture promotes healthy living, excellent work/life balance, and career advancement opportunities. MTM is a fun place to work, where individuality is encouraged and hard work is rewarded.

The Claims Outreach Specialist will be responsible for verification of scheduled appointments and claimed trips through communication with medical facilities, members and transportation providers. It requires tracking and documentation of findings in the business system as well as establishing and organizing regular correspondence with various medical facilities across the country. The Ideal candidate for this position will have excellent customer service skills.

This position is located at our office in Lake Saint Louis, MO.

Responsibilities:

  • Request verification for scheduled and/or claimed appointments with medical providers and facilities
  • Use best judgment of data at hand to determine whether a member should be educated on compliance, be placed on funding restrictions, or flagged for possible fraud, waste and abuse
  • Accurately document verification findings thoroughly in the business system being utilized within the Claims Department
  • Develop excellent rapport with facilities and organize regularly scheduled appointment, as needed, for verification
  • Ensure plan requirements specific to appointment verification are met for all clients, specifically the percentage of trips requiring verification
  • Maintain the required monthly performance metrics for verifying appointments
  • Develop and maintain relationship with multiple departments to ensure requirements are being met
  • Utilize excel and other business systems to monitor and manage verification work
  • Coordinate with Quality Management and CSC to enter account restrictions and answer questions
  • Coordinate with Accounting and Comdata and/or other monetary reimbursement methods to assist in payment issues and corrections

Minimum Qualifications:

  • High School Diploma or GED
  • Must maintain typing speed of at least 40 words per minute (WPM)
  • Intermediate level of proficiency or above with Microsoft Office Excel and Word
  • Experience in customer service preferred
  • Must be authorized to work in the United States and not require work authorization sponsorship by our company for this position now or in the future

Competency Based Qualifications:

  • Must possess the ability to make sound and quick judgment calls related to confidential information around issues that may have an adverse effect on the business, client or member
  • Must remain focused when performing the same task repeatedly
  • Must maintain positive attitude when answering the same questions or issues repeatedly
  • Experience navigating the internet and knowledge of using a computer
  • Must have the ability to learn new processes, programs, protocols, and adapt to change
  • Skilled in handling sensitive situations and people
  • Must have excellent judgment when it comes to handling or escalating possible fraud, waste and abuse
  • Ability to work independently and also collaboratively with others to achieve defined goals
  • Excellent written and verbal communication skills
  • Outstanding analytical and organizational skills and attention to detail

Whats in it for you?

  • Paid vacation
  • Holiday Pay
  • Health and Life Insurance Plans
  • Dental and Vision Plans
  • 401(k)
  • Onsite Gym
  • Wellness Screenings
  • Birthday Holiday
  • Training Development
  • Incentive Program
  • Casual Dress Environment
  • Scholarship Program
  • Healthy Market
  • Free Coffee

*These benefits may not be available at all locations

Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact Human resources at (636) 561-5686 or talent@mtm-inc.net

MTM

Why Work Here?

We offer employment opportunities that support both our traditional healthcare operations, as well as our transit operations through MTM Tra

From entry level customer service positions, to challenging technology and leadership roles, MTM offers a wealth of employment opportunities. Our corporate culture promotes healthy living, excellent work-home life balance, and strategic career advancement opportunities in a rewarding work environment where you will make a positive impact in your community and beyond. In particular, MTM is committed to providing physical activity and wellness opportunities for our employees, and we have been recognized as a Gold Level Recipient of the American Heart Association’s Fit-Friendly Worksites Recognition program. As an employer, MTM offers excellent benefits and welcomes diversity; we are an affirmative action and equal opportunity employer. We invite you to apply for any of our open positions and look forward to providing you an opportunity to develop your career as a member of our team.

Address

Lake Saint Louis, MO
USA

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