NY Licensed Claims Specialist

Job Summary

A company is looking for a Claims Resolution Specialist.

Key Responsibilities

• Contact healthcare providers to negotiate discounts on eligible claims
• Perform provider research and address counteroffers to achieve resolution
• Maintain compliance with HIPAA protocols and departmental performance metrics

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 applicable laws for Workers' Compensation or auto medical bills is a plus
• Experience with standard medical insurance claim forms and general office operations