Spec,Claims Res,OON,II-CS0956

Job Overview

At MultiPlan, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all.

Our dedication to service excellence extends to all of our stakeholders -- internal and external - driving us to consistently exceed expectations.

Job Description

We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.

Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and upward!!!

JOB SUMMARY: This position is responsible for contacting health care providers to negotiate certain type and dollar size health care claims/bills. Objective is to achieve maximum discounts and savings on behalf of the payor/client.

JOB ROLE AND RESPONSIBILITIES: 1. Foster and maintain provider relationship to facilitate current and future negotiations by * Performing claim research to provide support for desired savings.

* Generating agreements by communicating with providers by written and verbal communication throughout the negotiation process; and a. Address counteroffers received and present proposal for resolution while adhering to client guidelines and department goals.

b. Seek opportunities to achieve savings with previously challenging/unsuccessful providers. * Partnering with internal and external clients, including Account Managers, Customer Relations, Provider Services, and direct client contacts as applicable. 2.

Key Responsibilities

• Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare.
• JOB SUMMARY: This position is responsible for contacting health care providers to negotiate certain type and dollar size health care claims/bills.
• JOB ROLE AND RESPONSIBILITIES: 1.
• Foster and maintain provider relationship to facilitate current and future negotiations by * Performing claim research to provide support for desired savings.
• Partnering with internal and external clients, including Account Managers, Customer Relations, Provider Services, and direct client contacts as applicable.
• Manage high volume of healthcare claims in a queue; keep current with all claim actions and meet client deadlines for working and closing claims.
• The position responsibilities outlined above are in no way to be construed as all encompassing.
• Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary.

Required Skills and Qualifications

• Initiate provider telephone calls with respect to proposals, overcome objections and apply effective telephone negotiation skills to reach successful resolution on negotiated claims.
• Must be versatile to handle multiple clients with different requirements with different rules.
• Knowledge of Workers' Compensation or automobile medical ("auto") claims/bills is a plus: 5.
• Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary.
• JOB SCOPE: The individual in this position works under general supervision to complete job responsibilities in applying a fundamental knowledge of principles, practices and procedures related to the negotiation of health care claims/bills and provider agreements.
• Qualifications JOB REQUIREMENTS: (Education, Experience, and Training) * Minimum high school diploma or GED * Minimum of 2 years of experience in a service based industry preferably in the healthcare or medical insurance field (clinical, provider billing, provider collections, insurance or managed care preferred), or minimum 1 year experience as an Associate Claims Resolution Specialist/CRSI preferred.
• State licensure certification, including NY Health and/or P&C State Adjustor license, may be required.
• If hired without certification, certification must be obtained, and maintained thereafter, within six months of notification.

Benefits and Perks

• Qualifications JOB REQUIREMENTS: (Education, Experience, and Training) * Minimum high school diploma or GED * Minimum of 2 years of experience in a service based industry preferably in the healthcare or medical insurance field (clinical, provider billing, provider collections, insurance or managed care preferred), or minimum 1 year experience as an Associate Claims Resolution Specialist/CRSI preferred.
• Knowledge of medical coding systems (i.e., CPT, ICD-9/10, revenue codes) desired * Knowledge of general office operations and/or experience with standard medical insurance claim forms * Good Communication (verbal, written and listening), teamwork, negotiation, and organizational skills.
• Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity.
• This position is also eligible for health insurance, 401k and bonus opportunity.
• BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs.
• Your benefits will include: Medical, dental and vision coverage with low deductible & copay Life insurance Short and long-term disability 401(k) + match Generous Paid Time Off Paid company holidays Paid Parental Leave Tuition reimbursement Flexible Spending Account Employee Assistance Program Summer Hours EEO STATEMENT MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations.

Work Location and Schedule

This role is listed as Remote USA with location information shown as Remote USA. The employment type is Full Time.

About the Company

Claritev is the organization connected with this listing. USA Jobs Today displays this opportunity for job discovery only, so applicants should verify company details, application instructions, and eligibility on the official employer website.