Clinical Claims & Projects Coordinator

ADP, Inc.; Jericho (NY); On-site; USD 66,000 - 70,000; Full time

Job summary

IPRO is seeking a Claims Specialist for an in-office role at our Jericho, NY headquarters. You will coordinate clinical reviews projects, monitor requests, liaise with clinical partners, manage provider interactions, track deadlines, and develop project frameworks to support interagency communications.

Requirements include a Bachelor's degree in healthcare or related field (or an Associate with two years of relevant experience) and experience in medical billing or claims review.

Qualifications

• Bachelor's degree in healthcare, business, management digital studies or related field AND one year of experience in medical billing, auditing or claims review, appeals or dispute resolution in healthcare or insurance.
• OR Associate degree in related field AND two years’ experience in medical billing, auditing or claims review, appeals or dispute resolution in healthcare or insurance industries.
• Knowledge of collaborative project management software, electronic documents, and design.
• Ability to solve problems and work with peers, medical, analytical, and administrative staff.
• Excellent written and verbal communication, including phone manners.
• Ability to meet deadlines in time-sensitive environments.

Responsibilities

• Monitor appeal/dispute status and communication on client portals.
• Conduct initial eligibility reviews and recommend actions to internal team.
• Track and assign cases using software applications.
• Monitor and measure key performance indicators.
• Identify barriers, recommend solutions, and execute approved actions.
• Present case status in huddles and scrums using agile approaches.
• Schedule regular team status meetings and record decisions.
• Prepare billing invoices and liaise with Finance to track payments.

Skills

Project coordination

Communication

Problem solving

Independent work

Education

Bachelor's degree (healthcare/business/related)

Associate degree + 2 years experience

Tools

Project management software

Document management software

Job description

IPRO is seeking a Claims Specialist for an in-office role at our Jericho, NY headquarters. You will coordinate clinical reviews projects, monitor requests, liaise with clinical partners, manage provider interactions, track deadlines, and develop project frameworks to support interagency communications.

Requirements include a Bachelor's degree in healthcare or related field (or an Associate with two years of relevant experience) and experience in medical billing or claims review.