Grand Rounds' vision is to create a path to great health and health care, for everyone, everywhere. Founded in 2011, the company provides an employer-based technology solution that connects members and their families to high-quality care. With Grand Rounds, employers get a personalized, high-performance network at scale, while their employees get the tools and support needed to navigate their care on their own terms.
Named Glassdoor’s Best Place to Work in 2019 and Rock Health’s 2018 Fastest Growing Company, Grand Rounds helps restore individual health and quality of life, and offers employers lower health care spend and higher employee productivity. For more information, please visit www.grandrounds.com.
As a Claims Support Coordinator, you will be part of a vibrant team of high performing and highly engaged professionals that work to ensure a quality patient experience within our service level agreements. The Claims Support Coordinator role serves as a liaison between plan members, providers and health insurance companies to get claims issues resolved. The Claims Support handles all communication, paperwork, and negotiations with a health insurance carrier or provider on the behalf of the plan member.
Your primary objective is to provide effective and timely customer service for members, providers, insurer and clients regarding health care claims
Ensure timely follow-up on requests for accounts to be reviewed
Organize health insurance paperwork and medical record documentation
Demonstrate knowledge of proprietary software and other required technology (Google apps, etc)
Negotiate with providers on plan member balances
Challenge denials of claims by the insurance company
Communicate with medical offices, hospitals, laboratories, etc... in an effort to obtain relevant records for the patient’s case
Contact providers and insurance companies to resolve claim concerns
Assist with understanding of explanation of benefits (EOBs)
Enabling members to get the errors fixed and recoup or lower their expenses by resolving their: medical bills, denied medical claims, medical letters of appeal
Analyze and identify trends and patterns related to member billing complaints
Collaborate with peers and management across functions
Understand the evolving business requirements and adapt the operational processes to meet those requirements
Speak clearly, confidently and have a friendly phone demeanor while demonstrating persuasion in overcoming objections
Be able to handle a fast-paced dynamic environment with competing priorities
Model a culture reflective of our Core Company Values; gain and maintain a thorough understanding of the Patient Care Team policies, processes, software, etc.
3-5 years experience in healthcare customer service role
Passion for providing support
Prior work experience in a claims support or health insurance role preferred
Highly effective communication, problem resolution and organizational skills
Demonstrated ability to meet goals in a rapidly changing environment
Excellent data and overall analytical skills
Proven track record of driving measurable efficiency results
Medical billing/coding certification (CPC) beneficial, but not required
College degree preferred (additional experience in lieu of college degree will be considered)
Grand Rounds is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law. Grand Rounds considers all qualified applicants in accordance with the San Francisco Fair Chance Ordinance.