New York Licensed Claims Specialist

Job Summary

A company is looking for a Claims Resolution Specialist II.

Key Responsibilities

• Negotiate health care claims and maintain provider relationships to achieve maximum discounts
• Perform claim research and manage a high volume of healthcare claims while meeting client deadlines
• Communicate with providers throughout the negotiation process and ensure compliance with HIPAA protocols

Required Qualifications

• Minimum high school diploma or GED
• At least 2 years of experience in a service-based industry, preferably in healthcare or medical insurance
• State licensure certification may be required within six months of hire
• Knowledge of medical coding systems and general office operations preferred
• Ability to work independently and handle confidential information