Carrier Claims Liaison

Job description

Essential Job Duties and Responsibilities: At International SOS, we are in the business of protecting and saving lives. For 40 years, we have delivered customised security risk management, health, and wellbeing solutions to organisations worldwide. With a presence in 90 countries and a team of nearly 13,000 experts, we provide 24/7 support to help organisations fulfil their Duty of Care responsibilities. Now, we’re looking for talented individuals to join our team and make a difference. The Carrier Claims Liaison is responsible for submitting accurate, clean claims to insurance carriers in compliance with carrier-specific guidelines and procedures. This role is also responsible for generating accurate cost share invoices to civilians in accordance with carrier reimbursement details, and supports accounts receivable efforts by researching unpaid claims, preparing appeals for denied claims, and conducting follow-up activities to achieve timely and favorable claim resolution. Key Responsibilities: Reviews and extracts medical claims recorded in BiGGeR system daily, generates system invoices, prepares comprehensive invoice packages, and submits accurate, clean claims to insurance carriers in accordance with established carrier billing procedures. Maintains and updates the internal invoice tracking database, ensuring accurate recording of submitted invoices and related data to support effective invoice management and reporting. Tracks insurance carrier reimbursement details and relays the data to provider payment team to facilitate timely payments to providers Supports resolution of unpaid, denied or partially paid claims by working directly with insurance carriers and internal teams, such as Operations and Claims Management, Provider Payment, and Accounts Receivable staff members Generates accurate invoices for DOD Civilians’ cost-share collections and uploads the invoicing data to SharePoint for Collections Team review and processing. Maintains effective communication with supervisory and other management team, and provide timely and factual updates on all situations that may impact data integrity, productivity and/or efficiencies With supervision of Claims Support Manager, applies CPT, HCPS and ICD codes to submitted claims as deemed necessary Ensures protection of private health and personal information by adhering to all HIPAA and PCI compliance regulations for monitoring billing and reimbursement related data. Actively participates in day-to-day office activities, including a variety of meetings which may sporadically be held after normal business hours and task force groups to improve processes Completes additional, related duties as assigned by Claims Support Manager as needed Required Skills and Knowledge Experience with medical billing and collections Proficiency in Microsoft Office applications (Excel, Word, Outlook, PowerPoint) Required Competencies Works well under pressure Team player Attention to detail Excellent communicator Required Work Experience • Minimum of two (2) years of work experience in medical coding, insurance carrier billing, and collections • Proficiency in Microsoft Office applications (Excel, Word, Outlook, PowerPoint) Please note that International SOS is unable to provide visa sponsorship or employment-based immigration assistance for this position. To be considered, candidates must be authorized to work in the country of employment without requiring current or future sponsorship, including but not limited to H-1B, TN, or STEM OPT sponsorship.