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Copay Claims Processor

Details

TailorMed is a technology startup on a mission to make healthcare more accessible and affordable for U.S. patients. To solve such a complex challenge, it takes a village, or as we say at TailorMed, a network! We’ve built the nation’s largest network of providers, pharmacies, partners, and life sciences companies who have joined us in making treatment affordable for all patients across all medical conditions.

The TailorMed network is powered by a suite of advanced solutions designed to proactively identify patients who need help the most, match them to all available financial resources, and most importantly, make it easy for patients to utilize those resources.

This is what we mean by “moving mountains for patients” and we’re ridiculously passionate about it.

 

The Copay Claims Processor is a member of the TailorMed Complete team and serves as an extension of our customer’s internal teams.  This role helps improve financial outcomes for patients by using our platform to submit claims on the patient’s and provider’s behalf to the approved manufacturer or foundation copay program, and for our customers by helping them improve their financial performance as an organization.

Responsibilities

  • Submit copay claims through appropriate channels and follow through to payment posting 
  • Work closely with our Financial Navigation team to ensure accurate and timely processing of claims
  • Communicate with manufacturer copay programs and foundation copay programs to resolve any issues or discrepancies
  • Communicate effectively with customer’s revenue cycle department to resolve any issues or discrepancies 
  • Maintain accurate records of all claims processed
  • Meet productivity and quality standards

Requirements

  • 2+ years of experience in medical billing and coding, or financial navigation experience
  • Experience working with insurance providers and healthcare organizations
  • Knowledge of all insurance types
  • Excellent communication and organizational skills
  • Ability to work well in a fast-paced environment
  • Willingness to adhere to and work during customer’s business hours
  • High school diploma or equivalent required
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