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Other Health Insurance (OHI) Associate - Remote

Sentara Health Administration, Inc.
Columbus, OH

Quick Apply

Job Details

Full-time
1 day ago

Benefits

403(b) matching
Paid parental leave
Caregiver leave
Disability insurance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Parental leave
Employee assistance program
Vision insurance
401(k) matching
403(b)
Life insurance
Pet insurance

Qualifications

Medical claims processing
High school diploma or GED

Full Job Description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is recruiting for an Other Health Insurance (OHI) Associate - Remote!

Status: Full-Time, permanent position (40 hours)

Standard working hours: 8am to 5pm EST, M-F.

Location: Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, Wyoming

Job Description Summary:

Other Health Insurance (OHI) Associate is responsible for researching, verifying, maintaining, and updating member Other Health Insurance (OHI) information to ensure accurate coordination of benefits, claims processing, and enrollment records.

Primary Responsibilities

Research, verify, and update member OHI information.
Validate OHI for Sentara Commercial, Medicare, and Medicaid members.
Determine the Payer Order between coverages.
Investigate OHI inquiries.
Complete assigned work queues within SLA requirements.
Participate in user training and knowledge share sessions, and retain and apply

Education:

High School Diploma or GED REQUIRED

Experience:

2 years of Health Plan Claims Disbursements REQUIRED

Preferred Qualifications

Knowledge of OHI Businesses.
Experience in insurance, enrollment, claims, customer service, or data-entry experience.
Proficiency with Microsoft Office products -
Strong attention to detail and problem-solving skills.
Experience with QNXT, Facets, CSC, or similar healthcare systems.
Healthcare payer or managed care experience.

Knowledge, Skills, and Abilities

Healthcare insurance knowledge
Data integrity and accuracy focus
Critical thinking skills
Attention to Detail
Accuracy and Timeliness
Strong communication skills with the ability to engage on phone calls for research and resolution of OHI inquiries
Communicate complex information clearly and concisely.
Ability to work independently and take ownership of assigned work
Ability to work collaboratively with team members for their shared goals
Ability to manage multiple priorities
HIPAA Compliance
Ability to follow SOP and Job Aids and apply them.

Performance Indicators

Accuracy of OHI updates
Timely completion of work
Compliance with procedures
Support of data quality initiatives
Maintaining Productivity Targets

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-102496

Talroo-Health Plan

Healthcare, Health Pan, Health Insurance, Managed Care, MCO, Salesforce, QNXT, Other Health Insurance (OHI), Claims, Disbursements, Facets, CSC, enrollment, customer service, data-entry experience

Benefits: Caring For Your Family and Your Career

Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down – $10,000
Reimbursement for certifications and free access to complete CEUs and professional development
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Quick Apply

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