New York Licensed Claims Specialist

Job Summary

A company is looking for a Claims Resolution Specialist II.

Key Responsibilities

• Contact healthcare providers to negotiate discounts on eligible claims and maximize savings
• Perform provider research and address counteroffers to reach resolution while adhering to client guidelines
• Maintain provider database and handle post-claim inquiries, ensuring compliance with HIPAA protocols

Required Qualifications

• 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 general office operations and medical insurance claim forms
• Ability to work independently and handle confidential information