Post a new job
This job ad has been posted over 40 days ago...
0

applicants

Full-time Provider Dispute Resolution Specialist

at Zelis Payments in New Jersey

The primary role of the Resolution Specialist is to resolve provider disputes for Fee Negotiation, Network, Multi-Service and Bill Review & Audit claims; including renegotiating claims if the need arises. Individuals who succeed in this role will demonstrate excellent customer service skills, which include strong verbal and written communication skills. This position will be responsible for metrics such as average time to resolve a dispute, average savings retention, frequency of dispute handling, and accurate documentation; all in an effort to best service our clients and providers. Other requirements involve the delivery of prompt, accurate, and cost-effective service for clients, and to meet or exceed company and client expectations for service. The individual will use problem-solving skills to resolve issues with diplomacy and accuracy.

Key responsibilities:

Research and resolution of provider and client billing inquiries including renegotiating claims as necessary to secure savings, while meeting or exceeding department KPI goals.
Maintains tracking of all necessary information related to the research and resolution of assigned work.
Works closely with internal staff, including Client Services, Network and Vendor Management, Out of Network Services and Bill Review & Audit for coordinate and promptly resolve issues
Assists other department members in resolving complex claims or escalated provider issues.
Communicates directly with clients to provide status updates and notification of resolved issues
Maintain awareness of and ensure adherence to HIPAA and Zelis standards regarding privacy.
Provides coverage and support for the Customer Care Team when needed
Performs other related responsibilities as assigned.


Associate Degree preferred but not required • 1-2 years of medical claims experience • 3+ years of experience within healthcare industry • Outstanding written and verbal skills • Knowledge of MS Outlook, MS Work, MS Excel and Internet Explorer • Exceptional prioritization and organizational skills • Excellent customer service and telephone skills
Reference : Provider Dispute Resolution Specialist jobs


« Go back to category
Is this job ad fake? Report it!   
Recommend to a friend
Published at 06-10-2022
Viewed: 89 times