NY Licensed Medical Claims Specialist

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