Complaint Intake Representative – Federal Health Benefits (Multiple Openings, On-Site DC)

Total hourly compensation:  $24.20 per hour — about $50,300 a year at 2,080 paid hours

Location:  Frances Perkins Building, 200 Constitution Avenue NW, Washington, DC 20210

Schedule:  Full-time, Monday through Friday, scheduled within a 7:00 a.m. to 7:00 p.m. tour of duty

Tell us in your application whether you hold a current favorable federal suitability determination, and roughly how much notice you would need to start. Both materially affect where you sit on the roster.

The work

Providers and their billing offices file complaints against health plans under the No Surprises Act, the federal law protecting patients from surprise medical bills. The Agency has 60 days to respond to each one. Surge operators do the same work as the core team, at the same standard.

• Review each day's new complaints, identify what is being alleged, and route them correctly.
• Screen complaints against defined jurisdiction categories and flag the ones requiring notification to the Agency within two business days.
• Enter and maintain complaint records accurately in the Government's Technical Assistance Inquiry System (TAIS).
• Contact complainants for information missing from a filing and follow up until you have what is needed.
• Contact health plans by telephone and pre-approved e-mail templates, logging every contact and response.
• Keep complainants informed on unresolved cases and escalate a case that is not moving before it ages.
• Correct data errors in existing records and support recurring reporting to the Agency.

What you need

• High school diploma or equivalent.
• One year or more of data entry, case processing, claims, customer service, or administrative support experience. Health plan, medical billing, or federal case-processing experience is a strong plus.
• Comfort working in a case management or records system and typing accurately at volume.
• Clear written and telephone communication. You will be speaking with medical billing offices and health plan representatives.
• Ability to be reliably on-site in downtown Washington, DC.
• U.S. person status, and the ability to obtain and maintain a favorable federal suitability determination (Minimum Background Investigation / Trusted Workforce 2.0 moderate). No work may begin before that determination is favorable.