Role Overview
This role is responsible for handling pre-claim and OON physician contract negotiations for all clients, reaching out to senior management at facilities across the country to secure lowest settlement rate. The position works independently under minimal supervision to complete assigned job responsibilities.
What You Will Do
Handles facility, provider, and client inquiries regarding pre-claims and OON physician contract requests; secures signed agreements for reimbursement with providers; researches claims to confirm history with the provider; determines cost-saving opportunities and pricing optimization strategies.
Why It Might Be a Fit
The ideal candidate will have a minimum high school diploma plus two years' experience in a medical healthcare claims role, with a background in healthcare claims management, negotiation experience, and strong organizational and communication skills.
Requirements
- Minimum high school diploma plus two years' experience in a medical healthcare claims role
- Background in healthcare claims management environment
- Demonstrated negotiation experience
- Proactive, self-starter
- High level of professionalism, organization, and flexibility
- Strong organizational skills, attention to detail
- Strong communication skills, oral and written
- Ability to manage high call volume
- Ability to multi-task effectively
- Detail focused
- Self-motivating personality and professional demeanor
- PC literate, including Microsoft Office products and web-based applications
- Required licensures, professional certifications, and/or Board certifications as applicable
Benefits
- Medical, dental, and vision coverage with low deductible & copay
- Life insurance
- Short and long-term disability
- Paid Parental Leave
- 401(k) + match
- Employee Stock Purchase Plan
- Generous Paid Time Off
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Sick time benefits
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