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Claims Specialist / Contract

Location

New York

Posted

83 days ago

Salary

$39 / hour

Seniority

Mid Level

English

Job Description

Claims Specialist / Contract

GreenLife Healthcare Staffing

JOB TITLE (#24995B): Claims Specialist / Contract - Remote 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 New York, NY 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.

Job Requirements

  • REQUIREMENTS:
  • Must have a bachelor's or advanced degree in healthcare, business, management, digital studies, or a 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

  • Benefits of the Claims Specialist:
  • The salary for this position is $39/ hr
  • This is a Full-time position
  • 1 Week of Paid Vacation based on accruals after 3 months of employment (2 weeks of Paid Vacation with accrual starting your second year of employment)
  • 6 Major Paid Holidays per year
  • 5 Sick Days (40 Hours) subject to the provisions of NYS Paid Sick Leave Act
  • License Reimbursement after 1 year of employment
  • Health Insurance is subject to plan eligibility requirements
  • 401k Matching eligibility after 1 year of employment

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