Remote Negotiation Specialist (Tech Operator III)

MedRisk; United States; Remote; USD 70,000 - 100,000; Full time

Job summary

MedRisk is seeking a Negotiation Specialist (Technical Operator III) to evaluate, negotiate, and settle workers’ compensation claims. The role partners with providers, adjusters, and internal teams to ensure cost-effective, fair outcomes while upholding service standards.

The position requires 2–5 years of experience, strong knowledge of regulations, and proficiency in medical coding and claims systems. It is a fully remote, full-time opportunity within a dynamic IQ Analysis team.

Qualifications

• 2–5 years of workers’ compensation claims handling, bill review, or negotiation experience.

Responsibilities

• Review and analyze medical bills, treatment records, and claim documentation to determine settlement values.
• Negotiate with medical providers and other parties to reach fair, timely resolutions.
• Ensure compliance with state workers’ compensation laws and regulations.
• Maintain accurate documentation of negotiations and outcomes in the claims system.
• Identify cost-saving opportunities to minimize claim exposure.
• Communicate clearly with internal and external contacts.
• Monitor claims to identify trends and report concerns.

Skills

Workers’ comp claims handling

Regulations & fee schedules

Medical billing codes CPT ICD-10 HCPCS

Communication & negotiation

Detail orientation & multitasking

Claims management systems

Microsoft Office proficiency

Job description

MedRisk is seeking a Negotiation Specialist (Technical Operator III) to evaluate, negotiate, and settle workers’ compensation claims. The role partners with providers, adjusters, and internal teams to ensure cost-effective, fair outcomes while upholding service standards.

The position requires 2–5 years of experience, strong knowledge of regulations, and proficiency in medical coding and claims systems. It is a fully remote, full-time opportunity within a dynamic IQ Analysis team.