Claims Specialist / Contract - Lake Success or Albany, NY (#25148)
Preferably has 2 years of collaborative project support
Greenlife Healthcare Staffing is currently seeking a Claims Specialist to fill an opening with a Non-profit organization located in Lake Success or Albany, New York.
Responsibilities of the Claims Specialist :
- Act as point-of-contact for appeal / dispute adjudication programs.
- Liaise with healthcare plans, providers, patients, and clients to coordinate requests, correspondence, and submission of case documentation, as necessary.
- Monitor appeal / dispute status and communication received on client portals.
- Conduct initial eligibility reviews and recommend a course of action to internal team and department management.
- Track and assign cases using commercial off-the-shelf and custom software applications.
- Review and provide case documentation to assigned billers / coders, nurses, physicians and clinicians internal teams, and key stakeholders to facilitate clinical and coding reviews.
- Monitor and measure key performance indicators including, but not limited to, timeliness, adherence to quality and accuracy standards, and deadlines for contract deliverables.
- Identify barriers and roadblocks in work processes, recommend solutions to solve problems, and execute approved solutions.
- Routinely present case / project status in huddles and scrums while using an agile, iterative approach to implementation and data presentation.
- Schedule regular team status meetings and record decisions (e.g., assigned tasks and next steps).
- Prepare billing invoices at the conclusion of cases, submit them to the Finance department, and liaise with accounting to track and trend payments
- Mentor and train new staff, at all levels, on process steps and case progression.
- Other activities as may be deemed necessary
Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
Requirements
- Must have a bachelor's or advanced degree in healthcare, business, management digital studies, or related field.
- 2 years of collaborative project support is preferred however new graduates will be considered.
- Must have knowledge and experience with collaborative project management software, electronic documents, and design.
- Must have the ability to problem solve and work collaboratively with peers, and medical, analytical, and administrative support staff.
- Must have excellent written and verbal skills including phone manners.
- Must have the ability to work independently with little supervision.
- Must have the ability and desire to be flexible, innovative, and creative while multi-tasking.
- Must have the ability to meet deadlines in a time-sensitive environment.
Benefits
- The salary for this position is $39 / hr
- This is a Full-time position
- 2 Weeks Vacation
- 6 Major Holidays
- 5 sick days
Excess and Surplus Claims Specialist
Excess and Surplus Claims Specialist. AmTrust Financial Services, a fast growing commercial insurance company, is seeking an experienced Claims Specialist III for a role in Excess and Surplus Lines (E&S) General Liability. Minimum of five (5) years of experience in the handling of litigated and non-...
Senior Claims Specialist - PIP (hybrid)
The Senior Claims Specialist role will handle more serious and complex PIP claims. Include performing all duties and responsibilities as outlined for Claims Specialist. Performing special claims investigation and handling matters requiring broad technical claims knowledge. Claims Specialist or 3-4 y...
Claims Data & Analytics Specialist
The Amtrust Claims Workers' Compensation and Managed Care Analytics team is looking for a Claims Data & Analytics Specialist who will be responsible for supporting the Claims organization by providing analytics and identifying opportunities to improve efficiency and effectiveness, as well as communi...
Claims Specialist
Claims Specialist / Contract - Lake Success or Albany, NY (#25148). Greenlife Healthcare Staffing is currently seeking a Claims Specialist to fill an opening with a Non-profit organization located in Lake Success or Albany, New York. Responsibilities of the Claims Specialist:. ...
Senior Claims Technical Operations Specialist
Senior Claims Technical Operations Specialist. The Technical Operations Specialist position will work with internal and external stakeholders and will report to the AVP of Claims Operations. It will require the individual to possess an excellent understanding of the (LOB) Claims business functions, ...
Claims Specialist
Claims Specialist / Contract - Lake Success or Albany, NY (#25148). Greenlife Healthcare Staffing is currently seeking a Claims Specialist to fill an opening with a Non-profit organization located in Lake Success or Albany, New York. Benefits of the Claims Specialist:. Responsibilities of the Claims...
Claims Technical Specialist
Join our dynamic team as a Claims Technical Specialist! In this role, you will be the cornerstone of our customer service experience, providing accurate and timely assessments of vehicle damage and coordinating the claims process. Your expertise in auto body repair estimates, insurance policies, and...
Claims Client Service Specialist
We are hiring in our P+C Upstate Division for a Claims Client Service Specialist!. Process claims as applicable including follow up on outstanding claims and aid with resolution as necessary. Promptly report all possible E&O claims and potential E&O claims. Adhere to workflow procedures and follow g...
Senior Claims Specialist - Property
American National is hiring a Senior Property Claims Specialist to become part of a dynamic group dedicated to providing top-notch claims service. In this role, you will handle complex property claims, conduct thorough investigations, and work closely with policyholders to ensure a fair and efficien...
Field Property Claims Specialist, NYC
Ability to exercise independent judgment and make critical business decisions effectively assessing the merits of claims as well as evaluating claims based on a cost benefit analysis. Handles commercial property claims in the field, generally with moderate to high complexity and loss exposure of $20...