Healthcare Claims & Provider Services Specialist II

Green Light Cost Management; Scottsdale (AZ); Sur place; USD 60 000 - 90 000; Plein temps

Résumé du poste

Green Light Cost Management is seeking an experienced healthcare operations professional in Scottsdale to manage claims and provider-service matters from intake to resolution.

You will review claims, identify discrepancies, track deadlines, and support appeals and negotiations while maintaining confidential case records and effective communications with providers, health plans, and clients.

Qualifications

• Experience in healthcare claims, provider services, reimbursement, or dispute resolution.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication.
• Ability to independently manage multiple cases, priorities, and deadlines.
• Strong judgment and problem-solving skills.
• Ability to learn and apply detailed processes.
• Familiarity with Microsoft Office and electronic recordkeeping tools.
• Reliability and confidentiality.

Responsabilités

• Review claims, case information, and supporting documentation.
• Manage cases from intake through resolution.
• Identify discrepancies, missing information, and escalation needs.
• Track deadlines, documentation, follow-ups, and case activity.
• Support appeals, reimbursement disputes, negotiations, and complex case resolution.
• Communicate with providers, billing offices, health plans, clients, and internal teams.
• Prepare case summaries, correspondence, and supporting documentation.
• Research and apply policies, procedures, and regulatory requirements.
• Maintain accurate case records and confidential information.
• Take ownership of complex cases and determine appropriate next steps.

Connaissances

Attention to detail

Organizational skills

Written communication

Verbal communication

Independent case management

Problem-solving

Learning and applying processes

MS Office

Recordkeeping tools

Confidentiality

Outils

Microsoft Office

Electronic recordkeeping tools

Description du poste

About Green Light

Green Light is a growing healthcare technology company that partners with healthcare providers and health plans to improve the healthcare claims and dispute-resolution process.

We're looking for an experienced healthcare operations professional who can independently manage claims and provider-service matters and help move complex cases toward resolution.

What You'll Do

• Review claims, case information, and supporting documentation
• Manage cases from intake through resolution
• Identify discrepancies, missing information, and escalation needs
• Track deadlines, documentation, follow-ups, and case activity
• Support appeals, reimbursement disputes, negotiations, and complex case resolution
• Communicate with providers, billing offices, health plans, clients, and internal teams
• Prepare case summaries, correspondence, and supporting documentation
• Research and apply policies, procedures, and regulatory requirements
• Maintain accurate case records and confidential information
• Take ownership of complex cases and determine appropriate next steps

Depending on your background, you may also support IDR, Open Negotiations, No Surprises Act workflows, grievances and appeals, provider or payer negotiations, and regulatory matters.

What We're Looking For

• Relevant experience in healthcare claims, provider services, reimbursement, appeals, dispute resolution, legal support, or a related field
• Strong attention to detail and organizational skills
• Excellent written and verbal communication
• Ability to independently manage multiple cases, priorities, and deadlines
• Strong judgment and problem-solving skills
• Ability to learn and consistently apply detailed processes and requirements
• Comfortable using Microsoft Office and electronic recordkeeping tools
• Dependable, accountable, and comfortable taking ownership
• Commitment to confidentiality

Experience with the No Surprises Act, IDR, Open Negotiations, healthcare reimbursement, claims/appeals, provider negotiations, or regulatory matters is especially valuable.

If you're experienced, dependable, and ready to take ownership of meaningful healthcare operations work, we'd love to hear from you.