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Job Description
*Your Future Evolves Here* Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states.
We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission.
Join a mission with a company behind it Why We’re Worth the Application:* + We continue to grow year over year. + Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts (https://www.evolenthealth.com/diversity) . + Achieved a 100% score two years in a row on the Human Rights Campaign’s Corporate Equality Index making us a best place to work for LGBTQ+ equality. + Named to Parity.
org’s 2020 list of the best companies for women to advance (https://www.evolenthealth.com/about-us/press-releases/8579/evolent-health-named-to-parity.org%E2%80%99s-best-companies-for-women-to-advance-list-2021) .
+ Continued to prioritize the employee experience and achieved an 87% overall engagement score on our last employee survey. + Published an annual DE&I report (https://dev.evolenthealth.com/sites/default/files-public/Evolent%20Health%202020%20DE%26I%20Annual%20Report.
pdf) to share our progress on how we’re building an equitable workplace What You’ll Be Doing:* The Provider Claims Liaison will support the Market Operations team for one of Evolent’s Medicaid partners. As a Provider Claims Liaison, you will use expertise in claims and provider interaction to assist providers with claims and configuration-related issues they may be experiencing. This position provides claims analysis, summaries, and guidance to providers to assist with the handling of escalated claims processing and configuration issues Essential Duties and Responsibilities May Include:* + Serve as provider resource to handle escalated claims and configuration issues.
These functions may include claims research, claims analysis, and other duties as needed + Serve as internal liaison within Evolent and have direct line access to the Evolent department leads for escalated issues + Serve as subject matter expert on specific claims and configuration issues via email and on phone calls with providers + Educate providers, as necessary. + Acknowledge receipt of provider inquiries within 2 business days. + Provide status updates to providers with open claims and configuration issues no less than weekly + Track and report out on issue volume, priority, and resolution status both internally and externally + Effectively operate in a Matrix reporting environment with a reporting structure accountable both to the Evolent market leadership and the central Evolent claims organization Preferred Experience We Look For:* + Minimum 2 years of healthcare claims adjudication or provider relations experience.
+ Ability to understand all facets of claims processing. + Ability to develop action plans for providers to overcome future claims re-processing events. + Ability to build strong provider relationships.
+ Strong organizational, multi-tasking and time-management skills. + Experience with rapidly adapting to process changes. + Requires strong competency with Microsoft Office.
+ Proven ability to work independently and as a team member. + Excellent communication (written and oral) and interpersonal skills. + Extremely organized and detail-oriented with exceptional follow through skills.
+ Ability to multi-task in a fast-paced environment and adapt quickly to change. + Ability to conduct written and verbal conversations with providers on billing related concerns Technical Requirements:* Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed Internet over 10 Mbps and specifically for all call center employees, the ability to plug in directly to the home Internet router.
These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply.
We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.
* Compensation Range: The minimum salary for this position is $62000, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts..
