TPL Claims Representative

Job Summary

The purpose of this position is to assist hospitals in resolving accounts that are related to an accident. Specifically, this position is focused on the effort to obtain accident details and insurance information from hospital patients and from other sources (all contact being made over the telephone), to request hospital liens and bills to be submitted to identified insurance carriers, and to communicate with both insurance adjusters and personal injury attorneys during the claims adjudication process to ensure that the hospital receives payment on submitted bills and/or liens.

Essential Duties And Responsibilities

• Maintain a queue of Third-Party Liability accounts as assigned by management.
• Maintain an average of 60 unique accounts worked per day (8 unique accounts worked per hour) once full job proficiency has been achieved.
• Contact hospital patients via telephone to obtain accident details and insurance information. Support hospital patients by answering any questions about the Third-Party Liability process.
• Obtain accident reports from law enforcement agencies in the event that the patient cannot provide the necessary accident details and/or insurance information.
• Submit hospital bills to insurance companies for payment, and request hospital liens to be filed, as applicable.
• Maintain contact with insurance adjusters and/or personal injury attorneys during the claims adjudication process to ensure that the hospital bill/lien is paid timely and in full.
• Provide updates to Elevate PFS’s account management system as account work is completed; this is done by selecting the applicable option from an account status menu and writing a detailed note explaining what information was obtained and what transpired during the act of working each account.
• Assist management with ad hoc inventory initiatives and other projects, as needed.
• Other duties as assigned.

Qualifications And Requirements

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.
• High school diploma or GED required
• Minimum one-year experience working hospital revenue cycle processes preferred
• Knowledge of and compliance with State and Federal regulations that govern collection practices, such as HIPAA and FDCPA. Knowledge of or experience working with hospital lien statutes, or paperwork pertaining to other statutory regulations, is a definitive advantage
• Intermediate knowledge of Outlook, Word, and Excel
• High commitment to customer service and high levels of empathy and understanding.
• Dependable and highly detailed individual with strong organizational skills
• Remote and Hybrid positions require a home internet connection that meets the company’s upload and download speed criteria.

Benefits

ElevatePFS believes in making a positive impact not only within our industry but also with our employees –the organization’s greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.

• Medical, Dental & Vision Insurance
• 401K (100% match for the first 3% & 50% match for the next 2%)
• 15 days of PTO
• 7 paid Holidays
• 2 Floating holidays
• 1 Elevate Day (floating holiday)
• Pet Insurance
• Employee referral bonus program
• Teamwork: We believe in teamwork and having fun together
• Career Growth: Gain great experience to promote to higher roles

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.

The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

ElevatePFS is an Equal Opportunity Employer