New York Licensed Claims Specialist

A company is looking for a Claims Resolution Specialist responsible for negotiating healthcare claims to achieve maximum discounts and savings.

Key Responsibilities

Manage a high volume of healthcare claims to maximize savings opportunities through provider negotiations

Perform provider research and address counteroffers to achieve favorable resolutions

Maintain compliance with HIPAA protocols and meet established departmental performance metrics

Required Qualifications, Training, and Education

Minimum high school diploma or GED

At least 6 months of experience in the healthcare industry; 1 year preferred

State licensure certification may be required and must be obtained within six months if hired without it

Knowledge of general office operations and standard medical insurance claim forms

Ability to work independently and handle confidential information