NY Licensed Medical Claims Specialist

Job Summary

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

Key Responsibilities

• Negotiate healthcare claims with providers to achieve maximum discounts and savings
• Perform claim research and generate agreements through effective communication
• Manage a high volume of claims while maintaining established performance metrics

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, with a six-month timeframe to obtain if not already certified
• Knowledge of medical coding systems and standard medical insurance claim forms is desired
• Ability to work independently and handle confidential information