RCM Customer Service Manager

1 Month ago • 3-5 Years • Customer Service

Job Summary

Job Description

Jasper Health is seeking an RCM Customer Service Manager to lead administrative operations, including staff and service administration. The role focuses on managing operational processes to drive revenue growth, improve technical productivity, and enhance customer satisfaction. Key responsibilities include verifying insurance, obtaining pre-authorizations, explaining financial responsibilities to patients, educating them about their coverage, informing clinical staff of denials, answering billing and insurance questions, estimating cash payments, verifying customer and insurance data, and maintaining confidentiality. The manager will also review batch claims for submission, work denials and ERAs, and process payments. The ideal candidate will have 3-5 years of experience in customer service (preferably from a high-volume health plan call center), provider relations, and claims/billing, along with strong administrative skills.
Must have:
  • 3-5 years customer/member service experience
  • 3-5 years provider relations experience
  • 3-5 years claims and billing experience
  • Strong administrative skills
  • Understanding of medical terminology
  • Ability to interact with patients and insurance companies
Good to have:
  • Experience from a health plan with a high-volume call center
  • Experience handling referrals
  • Experience with insurance verification, member benefits and eligibility
  • Experience with explanation of benefits, ERA
Perks:
  • Flexible Paid Time Off (PTO)
  • Health, Dental and Vision Insurance
  • Short Term / Long Term Disability
  • Life Insurance
  • 401(k) Retirement Plan
  • Flexible Spending Accounts
  • Employee Assistance Program

Job Details

Who We Are

Jasper Health pairs people experiencing cancer with American Cancer Society-certified counselors for virtual, 1-on-1 support.. Our team of healthcare, technology, and consumer industry experts are dedicated to making cancer care a more human experience. Jasper Health raised $25M in Series A funding led by General Catalyst. The round, which was joined by new and existing investors Human Capital, W Health Ventures, Redesign Health, and 7wireVentures, brings Jasper Health's total funding to approximately $31 million.

Jasper Health has a passionate team of world-class leaders in digital health, oncology, customer-centered design, and data science. We are rapidly adding talent to our team - come join us!

Reporting to the Director of MSO Operations, this role will be responsible for the strategic direction and leadership for the overall administrative operations, which includes staff and service administration. This role is to effectively and efficiently manage the development and directions of the operational processes to drive the growth of revenue, technical productivity and promote high quality satisfaction while building relationships (internal and external) and ensuring the integration of strategic plans with company operations.

Role and Responsibilities

  • Verifying insurance: Checking the status of new and existing patients' insurance, and updating information as needed 
  • Obtaining pre-authorization: Calling to get pre-approval for recommended services and procedures 
  • Explaining financial responsibilities: Informing patients of their financial obligations 
  • Educating patients: Teaching patients about their insurance coverage 
  • Informing clinical staff: Notifying relevant clinical staff of denials 
  • Answering questions: Answering questions about billing and insurance 
  • Calculating cash estimates: Estimating cash for patients' upcoming visits or procedures 
  • Verifying customer and insurance data: Reviewing, correcting, deleting, or reentering data 
  • Maintaining confidentiality: Protecting patient information and maintaining customer confidence  
  • Strong understanding of medical terminology, such as CPT codes, diagnoses, and treatments. 
  • Ability to interact with patients and insurance companies over the phone and in person. 
  • Reviewing batch claims for submission.
  • Reviewing and working ERAs and denials.
  • Collecting co-payment, deductible, co-insurance and posting payments.

Knowledge, Skills, and Abilities Required

3-5 years of experience in each of the following areas

  • Customer/member service experience preferably from a health plan with a high-volume call center
  • Provider Relations - experience dealing with provider calls and handling referrals
  • Claims and billing – experience with insurance verification, member benefits and eligibility, explanation of benefits, ERA, etc.
  • General administrative skills – Microsoft, Google docs, etc.

Benefits Includes

  • Flexible Paid Time Off (PTO)
  • Health, Dental and Vision Insurance
  • Short Term / Long Term Disability
  • Life Insurance
  • 401(k) Retirement Plan
  • Flexible Spending Accounts
  • Employee Assistance Program
  • And more…

Conditions of Employment

  • You must be authorized to work in the United States
  • Applicants will be required to pass a background check as a condition of employment

Equal Employment Opportunity Policy

Jasper Health, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

#li-remote

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