New York Licensed Claims Specialist

Job Summary

A company is looking for a Claims Resolution Specialist II, OON.

Key Responsibilities

• Negotiate health care claims and bills to achieve maximum discounts and savings
• Maintain provider relationships and conduct claim research to support negotiations
• Manage a high volume of healthcare claims, ensuring compliance with client guidelines and 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 within six months of hire
• Knowledge of medical coding systems and general office operations
• Ability to work independently and handle confidential information