Philadelphia, Pennsylvania, United States · Hybrid
$70k/yr
Mid level
Overview Highlight Health is a profitable, fast-growing company that protects consumer rights and controls healthcare costs for self-funded plans. Highlight Health is redefining cost containment for self-funded health pl…
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$70k/yr
Full-time
bachelor degree
Healthcare Cost Reimbursement, Paid Time Off, Commuting Benefits, Short Term Disability, 401(k) Contribution, Bonuses
Posted 16d ago
~40 hrs/week
Responsibilities
Acts as the primary liaison between internal teams and external partners to streamline large claims analysis and resolutions. Manages claims inventory, leads stakeholder meetings, and produces summary materials for executive and external review.
Requirements
Requires strong interpersonal, organizational, and communication skills with the ability to manage tasks in a fast-paced environment. Medical or clinical knowledge is required, and a college degree is preferred.
Full job description
Overview
Highlight Health is a profitable, fast-growing company that protects consumer rights and controls healthcare costs for self-funded plans.
Highlight Health is redefining cost containment for self-funded health plans, participants, and stop-loss carriers. We save money for plans and participants, while assisting plan sponsors in fulfilling their fiduciary duties. We are an independent, nationally recognized healthcare cost containment company that uses innovative technology and sound industry knowledge and experience, to drive success. Our combination of expertise and technology sets the industry standard for independent healthcare cost containment and guidance services.
We are seeking a motivated, hard-working individual to help streamline and optimize the most crucial aspect of our business – large claims analysis and resolutions. The Large Claims Coordinator role will require strong interpersonal and organizational skills as well as the ability to prioritize and satisfy deadlines. The best candidates for this position should excel in inspiring confidence between a variety of internal teams as well as being able to communicate with external parties.
Essential Duties and Responsibilities
Serve as the primary liaison across Sales, Account Management, Legal, and Claims Analysis teams, as well as the main point of contact for external partners
Organize, prioritize, and initiate items that need to be completed amongst teams, and prioritize them based on internal and external factors
Manage the Large Claims inventory by running reports, monitoring daily activity and identifying risks, delays or process improvement opportunities
Lead multiple weekly meetings between key stakeholders to ensure large claims are being efficiently worked
Produce and disseminate materials summarizing claims analysis on large claims
Communicate findings to external parties in both written and presented formats
Assist executives in any other duties as required as it relates to the working of large claims
Draft and distribute materials for both internal and external usage that explains HLH processes for Large and Special claims
Experience and Qualifications
Ability to organize and prioritize a variety of tasks in a fast-moving environment
Strong interpersonal and problem-solving skills
Strong communication skills
Ability to take initiative and build out necessary resources and workflows
Medical/clinical knowledge
College degree preferred
Compensation and Benefits
Compensation:
Starting Salary: $70,000
Benefits:
Highlight Health offers an attractive benefits package, with healthcare cost reimbursement, paid time off, commuting benefits, short term disability, an employer 401(k) contribution, and bonuses.
After 90 days of employment, you may work from home 2 days/week.
Highlight Health is redefining cost containment for self-funded health plans, participants, and stop-loss carriers. We save money for plans and participants, while assisting plan sponsors in fulfilling their fiduciary duties. We are an independent, nationally recognized healthcare cost containment company that uses innovative technology and sound industry knowledge and experience, to drive success. Our combination of expertise and technology sets the industry standard for independent healthcare cost containment and guidance services.
Offices: 399 Market St, Suite 320, Philadelphia, Pennsylvania 19106, US · 550 Broad St, Suite 1006, Newark, New Jersey 07102, US
HealthcareRepricingClaims AnalysisMedical Bill ReviewAppeals & EscalationsERISACost ContainmentSelf-Funded Health PlansStop-LossFiduciary Compliance
Highlight Health is redefining cost containment for self-funded health plans, participants, and stop-loss carriers. We save money for plans and participants, while assisting plan sponsors in fulfilling their fiduciary duties. We are an independent, nationally recognized healthcare cost containment company that uses innovative technology and sound industry knowledge and experience, to drive success. Our combination of expertise and technology sets the industry standard for independent healthcare cost containment and guidance services.
Offices: 399 Market St, Suite 320, Philadelphia, Pennsylvania 19106, US · 550 Broad St, Suite 1006, Newark, New Jersey 07102, US
HealthcareRepricingClaims AnalysisMedical Bill ReviewAppeals & EscalationsERISACost ContainmentSelf-Funded Health PlansStop-LossFiduciary Compliance