Claims Payables Specialist

Job Summary

To ensure the accuracy and compliance of healthcare reimbursements, the full-time remote Claims Payables Specialist will process and adjudicate value-based care claims while maintaining documentation and collaborating with various departments.

Key responsibilities

• Process and adjudicate value-based care claims in accordance with established policies and regulatory requirements
• Review processed claims for accuracy and compliance with contractual agreements and reimbursement guidelines
• Investigate and resolve discrepancies in claim information, collaborating with internal and external partners as needed

Required qualifications

• Thorough understanding of value-based care agreements and claims processing
• Experience in healthcare reimbursement models and regulatory compliance
• Proficiency in maintaining accurate documentation of claims processing activities
• Ability to collaborate effectively with various departments and manage provider relationships
• Commitment to continuous improvement and process optimization in claims workflows