Spec,Claims Res,OON,II-CS0956

Role Overview

This position is responsible for contacting healthcare providers to negotiate certain type and dollar size healthcare claims/bills. The objective is to achieve maximum discounts and savings on behalf of the payor/client. The role requires fostering and maintaining provider relationships, performing claim research, and generating agreements through written and verbal communication.

What You Will Do

Initiate provider telephone calls, overcome objections, and apply effective telephone negotiation skills to reach successful resolution on negotiated claims. Meet and maintain established departmental performance metrics, manage high volumes of healthcare claims, and collaborate with internal and external clients.

Why It Might Be a Fit

The ideal candidate will have a minimum of 2 years of experience in a service-based industry, preferably in the healthcare or medical insurance field. They will also possess strong communication, negotiation, and organizational skills, as well as the ability to work in a fast-paced environment and handle confidential information.

Requirements

• Minimum high school diploma or GED
• Minimum of 2 years of experience in a service-based industry
• State licensure certification, including NY Health and/or P&C State Adjustor license
• Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes)
• Knowledge of general office operations and/or experience with standard medical insurance claim forms
• Good Communication (verbal, written and listening), teamwork, negotiation, and organizational skills

Benefits

• Medical, dental and vision coverage with low deductible & copay
• Life insurance
• Short and long-term disability
• 401(k) + match
• Generous Paid Time Off
• Paid company holidays
• Paid Parental Leave
• Tuition reimbursement
• Flexible Spending Account
• Employee Assistance Program
• Summer Hours

Originally posted on Himalayas