Claims Specialist

3 days ago

Albany, United States Greenlife Healthcare Staffing Full time $44
Claims Specialist / Contract - Lake Success or Albany, NY (#25148)

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 Lake Success or Albany, New York

REQUIREMENTS:
  • Must have a bachelor's or advanced degree in healthcare, business, management digital studies, or 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 of the Claims Specialist:
  • The salary for this position is $44/ hr
  • This is a Full-time position
  • The contract will be at least 6 months

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.

About Greenlife Healthcare Staffing:

We are committed to our core values: integrity, honesty, and transparencyFinding a new position as a physician or allied health professional or filling a critical vacancy in your practice, clinic, hospital, or skilled care facility can be stressful and time-consuming.At Greenlife our mission is to make this process easier for you and help you through all the steps necessary to find that perfect new position or the healthcare professional to round out your team.We understand that every situation is different and our approach reflects that: we value personalized interaction with job seekers and employers, our searches are customized not cookie-cutter and our results speak for themselves: Happy job seekers and employers who found the right professional match through our services.

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