New York Licensed Claims Specialist

A company is looking for a Claims Resolution Specialist.

Key Responsibilities

Manage a high volume of healthcare claims to maximize savings opportunities by contacting providers and presenting proposals

Perform provider research and address counteroffers while adhering to client guidelines

Initiate provider calls to negotiate claims and ensure compliance with HIPAA protocols

Required Qualifications, Training, and Education

Minimum high school diploma or GED

At least 6 months of experience in the healthcare industry; 1 year preferred

State licensure certification may be required within six months of hire

Knowledge of applicable laws and general office operations

Ability to work independently and handle confidential information