Payment Integrity Validation Specialist

Job Summary

A Payment Integrity Validation Specialist is an integral part of a dynamic team, aiding in the facilitation of coordination of benefits. Validation Specialists utilize access to insurance eligibility and claims payment information as well as outreach to insurance carriers to ensure member records are accurate. This role builds a foundation of knowledge that supports future advancement.

Hours: Day shift, 40-hour work weeks. During training, 8am - 5pm. Flexible schedule options available between 7am - 7pm after six months of employment.

Setting: Professional office environment (with remote opportunity available after six months of employment based on performance).

Compensation:  This is a non-exempt position at a very competitive hourly rate. Our comprehensive benefit package includes health and dental benefits, short-term disability plans, 401k with company matching, paid vacation policy and more. We also offer an onsite gym, cafe, and coffee shop.

Training:  The Rawlings Company takes great pride in providing exemplary training and development programs via in-person instruction. Training covers our state-of-the-art proprietary systems, Medicare and Commercial primacy rules, communication strategies, and many other tools to place Specialists on the path to success.

Responsibilities

• Verifies medical insurance eligibility data.
• Accurately documents data gathered.
• Meets daily production quotas.
• Follows specific timeframes to complete tasks.
• Uses multiple computer systems to work efficiently.
• Provides excellent customer service. 

Qualifications

• High School diploma, GED, or equivalent combination of education. Experience with health insurance is preferred, but not required.
• Excellent oral and written communication skills, including on the phone, are required.
• Ability to work well independently or in a team environment.
• Very strong attention to detail and organizational skills.
• Word and Excel proficiency required.
• Experience in the healthcare field is helpful, but not required. 

Physical Requirements

• Frequently remains in sitting position for long periods of time to perform duties
• Frequently concentrates for long periods of time, paying close attention to detail
• Frequently uses and views the computer using fingers, hands, and vision
• Frequently works in a well-lit, tempered environment
• Occasionally moves through office to communicate with other employees

Our Company

The Rawlings Company is looking for hard-working, talented people who share our commitment to excellence to join our Payment Integrity Team. The Rawlings Company has successfully provided cost containment services to the largest health insurers in the country for more than 40 years and continues to grow as an industry leader. 
 

Our Culture is focused on:

• The guiding principle of doing the right thing.
• Caring for our employees and taking pride in the work they do.
• Providing recognition and financially rewarding employees for their success.

Our Values are:

• Integrity and Trust
• Customer Service Excellence
• Innovation
• Diversity and Inclusion
• Honoring our Veterans and Their Service 

*Equal Employment Opportunity.  It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification.
*The Rawlings Group is an employment at will employer.

#INDHP