Claims Specialist

Job Summary

A company is looking for a Claims Resolution Specialist to manage healthcare claims negotiations for maximum discounts and savings.

Key Responsibilities

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

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, with a six-month timeframe to obtain if not already certified
• Knowledge of applicable laws and medical insurance claim forms is a plus
• Ability to work independently and handle confidential information in a standard office environment