In this role you will be investigating, confirming, paying or denying and resolving claims involving first and third party medical payments coverage or PIP that involve moderate to severe complexity.
This person will also be providing outstanding customer service and have the ability to handle a large volume of claims.
Responsibilities
- Analyze, review, and interpret policies to assess coverage
- Handle complex to highly complex Medpay / PIP files inclusive of 3rd party claimants
- Review and process reimbursement requests under the applicable 1st party medical coverage based on fee schedules, policy terms limits and reasonable or customary charges
- Analyze file documentation, medical bills, medical records, employment, wage information and other documentation provided
- Responds promptly to written or verbal inquiries from injured parties, medical providers, and attorneys
Requirements
- Comprehensive knowledge of medical terminology, CPT and ICD 10 codes
- 3+ years' experience handling Medpay and / or PIP claims, including understanding and interpreting auto policies
- Superior knowledge of and adherence to the state laws and regulations governing the handling of auto Medpay / PIP claims
- State adjuster's license where domiciled or obtained within 90 day of start date
- Exceptional organization skills while moving from task to task in a high pace environment
Compensation and Benefits
Benefits
Along with competitive pay, as a full-time Tesla employee, you are eligible for the following benefits at day 1 of hire :
Aetna PPO and HSA plans >
2 medical plan options with $0 payroll deduction
- Family-building, fertility, adoption and surrogacy benefits
- Dental (including orthodontic coverage) and vision plans, both have options with a $0 paycheck contribution
- Company Paid (Health Savings Account) HSA Contribution when enrolled in the High Deductible Aetna medical plan with HSA
- Healthcare and Dependent Care Flexible Spending Accounts (FSA)
- LGBTQ+ care concierge services
- 401(k) with employer match, Employee Stock Purchase Plans, and other financial benefits
- Company paid Basic Life, AD&D, short-term and long-term disability insurance
- Employee Assistance Program
- Sick and Vacation time (Flex time for salary positions), and Paid Holidays
- Back-up childcare and parenting support resources
- Voluntary benefits to include : critical illness, hospital indemnity, accident insurance, theft & legal services, and pet insurance
- Weight Loss and Tobacco Cessation Programs
- Tesla Babies program
- Commuter benefits
- Employee discounts and perks program
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