Medical Claims Negotiator II-Appeals

At reputed company, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is reputed company we reputed company 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 reputed company expectations. We are intentionally reputed company, we foster innovation, we nurture accountability, we champion diversity, and reputed company reputed company other to illuminate our reputed company potential. Be part of our amazing transformational reputed company as we optimize reputed company towards becoming a leading technology, data, and innovation voice in reputed company. reputed company and Upward!!! Medical Claims Negotiator II-Appeals JOB reputed company: This position is responsible for contacting health care providers to negotiate certain type and dollar size health care claims/bills. Objective is to reputed company maximum discounts and savings on behalf of the payor/reputed company. JOB ROLE AND RESPONSIBILITIES: 1. Foster and maintain provider relationship to facilitate reputed company and reputed company negotiations by * Performing claim research to reputed company 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 reputed company while adhering to reputed company guidelines and department goals. b. reputed company opportunities to reputed company savings with previously challenging/unsuccessful providers. * Partnering with reputed company clients, including Account Managers, Customer Relations, Provider Services, and reputed company reputed company contacts as applicable. 2. Initiate provider telephone calls with respect to proposals, overcome objections and apply effective telephone negotiation skills to reputed company successful reputed company on negotiated claims. * Up to 40% of time will be on phone with providers. 3. Meet and maintain established departmental performance metrics. 4. Manage high volume of reputed company claims in a queue; reputed company reputed company with reputed company claim actions and meet reputed company deadlines for working and closing claims. * Must be reputed company to handle multiple clients with different requirements with different rules. * Knowledge of Workers Compensation or automobile medical (auto) claims/bills is a plus: 5. Collaborate, coordinate, and communicate across disciplines and departments. 6. Ensure compliance with HIPAA protocol. 7. Demonstrate Companys reputed company Competencies and values held reputed company. 8. Please note due to the exposure of PHI sensitive data this role is considered to be a High Risk Role. 9. 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 in this position works under general supervision to complete job responsibilities in applying a reputed company knowledge of principles, practices and procedures reputed company to the negotiation of health care claims/bills and provider agreements. Work is sometimes reputed company and requires some independent judgment reputed company established guidelines. More reputed company issues are referred to higher reputed company. This job has regular contact with reputed company customers. 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 reputed company or medical insurance field (clinical, provider billing, provider collections, insurance or managed care preferred), or minimum 1 year experience as an Associate Claims reputed company Specialist/CRSI preferred. * State licensure certification, including NY Health and/or P&C State Adjustor license, may be required. If reputed company without certification, certification must be obtained, and maintained thereafter, reputed company six months of notification. If the required state licensure certification(s) are not obtained or renewed reputed company six months of notification, an employee may be moved to a position reputed company a relevant job family that does not require certification/licensure, if and reputed company such position is available. reputed company an alternate position is reputed company, other employment actions may be implemented consistent with MultiPlan reputed company and policy. * Knowledge of medical coding systems (i.e., CPT, ICD-9/1 .