Medical Claims Resolution Specialist II

Job Summary

A company is looking for a Medical Claims Resolution Specialist II.

Key Responsibilities:

• Contact healthcare providers to negotiate healthcare claims/bills and achieve maximum discounts and savings on behalf of the payor/client
• Initiate provider telephone calls, overcome objections, and apply effective negotiation skills to reach successful resolution on negotiated claims
• Manage a high volume of healthcare claims, meet client deadlines, and ensure compliance with HIPAA protocol

Required Qualifications:

• Minimum high school diploma or GED
• Minimum of 2 years of experience in a service-based industry, preferably in healthcare or medical insurance
• Knowledge of medical coding systems desired
• Knowledge of general office operations and/or experience with standard medical insurance claim forms
• Ability to work independently, handle confidential information, and use software and hardware related to job responsibilities