Contacts the administrative and billing staff of Out of Network (OON) providers to negotiate reduced rates.
Acquires knowledge of the medical claim processing for better understanding of the negotiation process.
Captures detailed notes on calls for future reference.
Creates customized agreements based on negotiated rates.
Analyzes data to determine negotiation trends.
This role will use complex systems used for claim processing.
Updates information on internal systems as well as client systems.
Education, Skills, Abilities, Experience
Bachelor’s degree preferred or equivalent experience.
6 months minimum experience in claim negotiations or claim processing.
Overall health insurance knowledge preferred.
Capable of using and maneuvering Desktop and telephony instruments and collaborative learning.
Demonstrates proficiency in the following team core and functional competencies:
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)