NY Licensed Claims Resolution Specialist

Job Summary

A company is looking for a Claims Resolution Specialist.

Key Responsibilities

• Manage a high volume of healthcare claims to maximize savings opportunities by contacting providers and presenting proposals
• Perform provider research and address counteroffers to achieve resolution while adhering to client guidelines
• Update provider database and handle post-claim closure inquiries, ensuring compliance with HIPAA protocol

Required Qualifications and Education

• 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 and general office operations is a plus
• Ability to work independently and handle confidential information