Technical Operator III

Medrisk Llc; California; Remote; USD 29,000 - 33,000; Full time

Job summary

Medrisk Llc is seeking a Negotiation Specialist (Technical Operator III) to evaluate, negotiate, and settle workers’ compensation claims in accordance with laws and internal policies. You will collaborate with providers, adjusters, and internal teams to achieve cost-effective, fair outcomes while maintaining a high standard of service.

The role requires 2–5 years of experience in claims handling or negotiation, strong knowledge of regulations and billing codes, excellent communication, and the

Qualifications

• 2–5 years of experience in workers’ compensation claims handling, bill review, or negotiation (or equivalent combination of education and experience).
• Strong knowledge of workers’ compensation regulations and fee schedules.
• Strong understanding of medical billing codes (CPT, ICD-10, HCPCS), state fee schedules, and PPO discounts
• Excellent communication and negotiation skills, both written and verbal
• Strong attention to detail and ability to manage multiple cases independently
• Excellent negotiation, communication, and analytical skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Proficient with claims management systems and Microsoft Office Suite.

Responsibilities

• Review and analyze medical bills, treatment records, and claim documentation to determine appropriate settlement values.
• Negotiate with medical providers, and other parties to reach fair and timely resolutions.
• Ensure compliance with all applicable state workers’ compensation laws and regulations.
• Maintain accurate and up-to-date documentation of negotiations and outcomes in the claims management system.
• Identify potential cost-saving opportunities and work toward minimizing claim exposure.
• Communicate clearly and professionally withboth internal and external contacts.
• Monitor claims to identify trends and report on potential areas of concern.

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Technical Operator III

Full Time Regular Clerical CA, US

2 days ago Requisition ID: 2757

Salary Range: $21.00 To $24.00 Hourly

Job Title: Negotiation Specialist (Technical Operator III)

Department: IQ Analysis
Reports To: IQ Analysis Manager
Location: Remote
Job Type: Full-Time

Job Summary:

The Negotiation Specialist is responsible for evaluating, negotiating, and settling workers’ compensation claims in compliance with applicable laws and internal policies. This role involves working closely with providers, adjusters, and internal teams to ensure cost-effective and fair outcomes while maintaining a high standard of service.

Key Responsibilities:

• Review and analyze medical bills, treatment records, and claim documentation to determine appropriate settlement values.
• Negotiate with medical providers, and other parties to reach fair and timely resolutions.
• Ensure compliance with all applicable state workers’ compensation laws and regulations.
• Maintain accurate and up-to-date documentation of negotiations and outcomes in the claims management system.
• Identify potential cost-saving opportunities and work toward minimizing claim exposure.
• Communicate clearly and professionally withboth internal and external contacts.
• Monitor claims to identify trends and report on potential areas of concern.

Qualifications:

• 2–5 years of experience in workers’ compensation claims handling, bill review, or negotiation (or equivalent combination of education and experience).
• Strong knowledge of workers’ compensation regulations and fee schedules.
• Strong understanding of medical billing codes (CPT, ICD-10, HCPCS), state fee schedules, and PPO discounts
• Excellent communication and negotiation skills, both written and verbal
• Strong attention to detail and ability to manage multiple cases independently
• Excellent negotiation, communication, and analytical skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Proficient with claims management systems and Microsoft Office Suite.

Preferred Qualifications:

• Experience in a TPA, insurance carrier, or medical cost containment company