NY Licensed Medical Claims Specialist

Job Summary

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

Key Responsibilities

• Negotiate health care claims and maintain provider relationships to achieve maximum discounts
• Perform claim research and manage high volumes of healthcare claims while meeting client deadlines
• Communicate effectively with providers to resolve counteroffers and proposals during negotiations

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 hiring
• Knowledge of medical coding systems and standard medical insurance claim forms is desired
• Ability to work independently and handle confidential information