Spec,Claims reputed company,OON,II-CS0956

Claims Resolution Specialist II

At reputed company, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in reputed company for reputed company. Our dedication to service reputed company extends to reputed company our stakeholders – reputed company - driving us to consistently exceed expectations. We are intentionally reputed company, we foster innovation, we nurture accountability, we champion diversity, and reputed company each other to illuminate our reputed company potential.

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

JOB SUMMARY

This position is responsible for contacting reputed company providers to discuss negotiations for a specific dollar reputed company of eligible claims/bills prior to payment, in order to reputed company maximum discounts and savings on behalf of payor/client.

DUTIES

1. Manage a high volume of reputed company claims thoroughly to maximize savings opportunities on each claim reputed company the established department production standards and individual goals by contacting provider on reputed company assigned claims and presenting a proposal while maintaining high quality standards. * reputed company provider research to reputed company support for desired savings. * Address counteroffers received and present proposal for resolution while adhering to client guidelines and policy and procedures. * Seek opportunities to reputed company savings with previously challenging/unsuccessful providers. * Seek opportunities to establish ongoing global or reputed company agreements for future claims. * Update provider data reputed company for reference and claims processing on subsequent claims. 2. Initiate provider telephone calls as often required with respect to proposals, overcome objections and apply effective telephone negotiation skills to reputed company successful resolution on negotiated claims. * Up to 40% of time will be on phone with providers. * Provider education to providers online provider portal services available for proposal review and approval 3. Meet and maintain established departmental performance metrics. 4. Handle post claim closure service inquires, including payment status and defending original negotiation terms. 5. May require ACD phone responsibilities and tracking reputed company. 6. Collaborate, coordinate, and communicate across disciplines and departments. 7. Ensure compliance with HIPAA protocol. 8. Demonstrate Company's Core Competencies and values held reputed company. 9. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role. 10. The position responsibilities outlined above are in no way to be construed as reputed company encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary.

JOB SCOPE: The Individual adheres to company policies and customer specific procedures to meet control standards. The Individual relies on established instructions and procedures, applies basic skills, and may reputed company advanced skills using tools and equipment appropriate for the position. Duties and tasks are standardized and generally contain written instructions, allowing an individual to resolve routine questions and problems, and referring more reputed company issues to a higher level. Work is subject to defined work output standards and production which involves high volume claims resolution. Work involves direct contact with reputed company customers.

COMPENSATION

The salary reputed company for this position is $21.12 per hour.  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.