Talent.com
Claims Specialist, Audit & Contracting

Claims Specialist, Audit & Contracting

LogixHealthBedford, MA, US
30+ days ago
Job type
  • Full-time
Job description

Job Description

Job Description

Location : On-Site in Dania, FL

This Role :

As a Claims Specialist, you will work with internal teams to provide cutting-edge solutions that will directly improve the healthcare industry. You’ll contribute to our fast-paced, collaborative environment and will bring your expertise to review and carry out processes on all out of network claims.

The ideal candidate will have strong technological skills, excellent interpersonal communication, and a well-rounded knowledge of insurance payers.

Key Responsibilities :

  • Review, organize, and file IDR emails and complete responses
  • Monitor and track fee requests from arbitrators, and compile and send supporting documentation to arbitrator
  • Work automation reports
  • Sort and file Good Faith negotiations and respond to carrier and / or arbitrator inquires
  • Submit claims through state arbitration portals

Qualifications :

To perform this job successfully, an individual must be able to perform each Key Responsibility satisfactorily. The following requirements are representative of the knowledge, skills, and / or ability required to perform this job successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the duties.

Required :

  • A well-rounded knowledge of insurance payers
  • Ability to communicate effectively verbally and in writing
  • Ability to create routine reports
  • Prior word processing, spreadsheet and internet software experience including proficiency with MS Teams, Word, Excel, and Outlook
  • Preferred :

  • One to two years related experience
  • Healthcare industry knowledge
  • Medical billing experience
  • Benefits at LogixHealth :

    We offer a comprehensive benefits package including health, dental and vision, 401(k), PTO, paid holidays, life and disability insurance, on-site fitness center and company-wide social events.

    About LogixHealth :

    At LogixHealth we provide expert coding and billing services that allow physicians to focus on providing great clinical care. LogixHealth was founded in the 1990s by physicians to service their own practices and has grown to become the nation’s leading provider of unsurpassed software-enabled revenue cycle management services, offering a complete range of solutions, including coding and claims management and the latest business intelligence reporting dashboards for clients in 40 states.

    Since our first day, we have had a clear vision of a better healthcare system and have continually evolved to get there. In addition to providing expert revenue cycle services, we utilize proprietary software to provide valuable financial, clinical, and other data insights that directly improve the quality and efficiency of patient care.

    At LogixHealth, we’re committed to Making intelligence matter through our pillars of Physician-Inspired Knowledge, Unrivaled Technology and Impeccable Service.

    To learn more about us, visit our website https : / / www.logixhealth.com / .

    Powered by JazzHR

    KfUBI6wYMz

    Create a job alert for this search

    Contracting Specialist • Bedford, MA, US

    Related jobs
    • Promoted
    Senior Technical Claims Specialist, Commercial Casualty Complex

    Senior Technical Claims Specialist, Commercial Casualty Complex

    Liberty Mutual InsuranceWestborough, Massachusetts, United States
    Full-time
    Schedule : Full-Time Salary Range : USD $82000.Job Category : Claims Description The Senior Technical Claims Specialist determines coverage, investigates complex and highly complex Commercial Casualty...Show moreLast updated: 10 days ago
    • Promoted
    Contact Center Specialist I

    Contact Center Specialist I

    BankTalent HQWestborough, MA, United States
    Full-time
    This is a Hybrid position located in Westborough, MA.The Bank requires to be on-site for training and onboarding.Following successful completion, discussion will be held regarding transition to hyb...Show moreLast updated: 30+ days ago
    • Promoted
    Clinical Payment Associate

    Clinical Payment Associate

    VirtualVocationsLowell, Massachusetts, United States
    Full-time
    A company is looking for a Clinical Payment Associate to support activities within Clinical Vendor Outsourcing.Key Responsibilities Support vendor outsourcing contracting administration and busin...Show moreLast updated: 2 days ago
    • Promoted
    Claims Adjuster - Outside Property

    Claims Adjuster - Outside Property

    StaffingWorcester, MA, US
    Full-time
    Position Overview : CAT adjusters handle property claims requiring field investigations and / or inspections.They must establish rapport with our insureds and maintain relationships with our agents, u...Show moreLast updated: 29 days ago
    • Promoted
    Insurance Agent -Canton, MA

    Insurance Agent -Canton, MA

    Horace MannCanton, MA, US
    Full-time
    Join Horace Mann and Unlock Your Financial Potential.Ready to take control of your financial future?.At Horace Mann, we are here to support you in achieving your goals and making a meaningful diffe...Show moreLast updated: 9 days ago
    • Promoted
    Claims Specialist - Rideshare Attorney Represented Injury Claims Adjuster

    Claims Specialist - Rideshare Attorney Represented Injury Claims Adjuster

    Liberty Mutual InsuranceWestborough, Massachusetts, United States
    Full-time
    Schedule : Full-Time Salary Range : USD $60000.Job Category : Claims Description At Liberty, you'll thrive in a hybrid setting that fosters in-person collaboration, innovation and growth.This approach...Show moreLast updated: 30+ days ago
    • Promoted
    Contract / AIA Billing Specialist

    Contract / AIA Billing Specialist

    Encore Fire ProtectionPawtucket, RI, US
    Full-time
    Encore Fire Protection is seeking a Contract Billing Specialist to join our high-performing finance team at our Pawtucket, RI headquarters. This is a great opportunity for a detail-oriented professi...Show moreLast updated: 30+ days ago
    • Promoted
    Auto Claims Adjuster - Hybrid

    Auto Claims Adjuster - Hybrid

    RandstadWorcester, MA, US
    Full-time
    Randstad in partnership with The Hanover Insurance Group are actively seeking an Associate Adjuster to join their Auto team in Worcester, MA starting in on a temp to hire basis.The Hanover Insuranc...Show moreLast updated: 19 days ago
    • Promoted
    Senior Claims Specialist, Financial Lines Management Liability

    Senior Claims Specialist, Financial Lines Management Liability

    Liberty Mutual Insurance GroupWestborough, MA, US
    Full-time
    Senior Claims Specialist, Financial Lines Management Liability.Liberty Mutual has an immediate opening for a Senior Claims Specialist, Financial Lines Management Liability position.In this role, wi...Show moreLast updated: 30+ days ago
    • Promoted
    Senior Technical Claims Specialist, Energy Complex

    Senior Technical Claims Specialist, Energy Complex

    Liberty Mutual Insurance GroupWestborough, MA, US
    Full-time
    Senior Technical Claims Specialist.Liberty Mutual has an immediate opening for a Senior Technical Claims Specialist to join our Energy Complex Team. The Senior Technical Claims Specialist determines...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Claim Adjudication PM / SM

    Remote Claim Adjudication PM / SM

    Insight GlobalWoonsocket, RI, US
    Remote
    Full-time
    Insight Global is seeking a Project Manager / Scrum Master for a fully remote, one-year contract with the potential to convert to a full-time employee. This PM / SM will support a new strategic initiati...Show moreLast updated: 5 days ago
    • Promoted
    Intern - Claims (Auto Property Damage)

    Intern - Claims (Auto Property Damage)

    Hanover Insurance GroupWorcester, MA, US
    Full-time
    Internship Opportunity At The Hanover.For more than 170 years, The Hanover has been committed to delivering on our promises and being there when it matters the most. We live our values every day, de...Show moreLast updated: 30+ days ago
    • Promoted
    Medicaid Enrollment Specialist

    Medicaid Enrollment Specialist

    VirtualVocationsLowell, Massachusetts, United States
    Full-time
    A company is looking for a Medicaid Enrollment Specialist.Key Responsibilities Serve as the primary subject matter expert for Medicaid enrollment, revalidations, and contract maintenance Prepare...Show moreLast updated: 24 days ago
    • Promoted
    New England Claims Specialist

    New England Claims Specialist

    CorVel Enterprise Claims, Inc.Boxboro, MA, US
    Full-time
    The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outco...Show moreLast updated: 4 days ago
    • Promoted
    Claim Service Specialist -Wakefield, MA - Hybrid

    Claim Service Specialist -Wakefield, MA - Hybrid

    Arbella Insurance GroupWakefield, MA, US
    Full-time
    Arbella Claim Service Specialist Opportunity.Claim Service Specialists are advocates for our customers.They talk directly with people who have recently experienced a loss, inspect the damage, and i...Show moreLast updated: 30+ days ago
    • Promoted
    Product Manager Healthcare Claims Expert

    Product Manager Healthcare Claims Expert

    Addison GroupMarlborough, MA, US
    Full-time
    Product Manager- Healthcare Claims Data.Claims data oriented - Must translate the claims data and build analytics.Offshore experience to work with development teams and give instructions.Cost utili...Show moreLast updated: 30+ days ago
    • Promoted
    Auditor - Internal - Full Time

    Auditor - Internal - Full Time

    Bally's CorporationLincoln, RI, United States
    Full-time
    Bally's Corporation (NYSE : BALY) is a global casino-entertainment company with a growing omni-channel presence.Bally's owns and operates 19 casinos across 11 states, along with a golf course in New...Show moreLast updated: 17 days ago
    • Promoted
    Regional Claim Consultant

    Regional Claim Consultant

    A.I.M. Mutual Insurance CompaniesBurlington, MA, US
    Full-time
    This is a field position with routine daily travel within our Northeastern Massachusetts and Southern New Hampshire territories. Do you enjoy analyzing complex or technically difficult workers' ...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Healthcare Compliance Auditor

    Healthcare Compliance Auditor

    VirtualVocationsWorcester, Massachusetts, United States
    Full-time
    A company is looking for a Healthcare Compliance Auditor - Enterprise Risk.Key Responsibilities Assist in reviewing coding, billing, and claims processing policies to develop compliance monitors ...Show moreLast updated: 7 hours ago
    • Promoted
    Insurance Verification Associate

    Insurance Verification Associate

    VirtualVocationsLowell, Massachusetts, United States
    Full-time
    A company is looking for an Insurance Verification Associate to verify insurance coverage and maintain medical documentation. Key Responsibilities Answer questions from customers, clerical staff, ...Show moreLast updated: 3 days ago