NY Licensed Medical Claims Specialist

MultiPlan Corporation; United States; Remote; USD 45,000 - 60,000; Full time

Job summary

A healthcare solutions company is seeking a Medical Claims Resolution Specialist II to work remotely. Responsibilities include negotiating health care claims, managing claims research, and collaborating with clients to ensure compliance. Candidates should have at least a high school diploma and 2 years of service industry experience, preferably in healthcare. This position offers a chance to work independently in a dynamic environment.

Qualifications

• Minimum high school diploma or GED.
• At least 2 years of experience in a service-based industry.
• Knowledge of medical coding systems and standard medical insurance claim forms is desired.

Responsibilities

• Negotiate health care claims and maintain provider relationships.
• Perform claim research and manage high volumes of healthcare claims.
• Collaborate with clients to facilitate negotiations and ensure compliance.

Skills

Negotiation skills

Ability to manage high volumes of claims

Collaboration with clients

Knowledge of medical coding systems

Education

High school diploma or GED

Job description

A company is looking for a Medical Claims Resolution Specialist II, Appeals (Remote).

Key Responsibilities

• Negotiate health care claims and maintain provider relationships to achieve maximum discounts
• Perform claim research and manage high volumes of healthcare claims while meeting client deadlines
• Collaborate with internal and external clients to facilitate negotiations and ensure compliance with HIPAA protocols

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 standard medical insurance claim forms is desired
• Ability to work independently and handle confidential information in a fast-paced environment