Claims Specialist / Contract

Greenlife Healthcare Staffing • Jericho, NY

1d

About The Position

Greenlife Healthcare Staffing is currently seeking a Claims Specialist to fill an opening with a Non-profit organization located in Jericho, New York. This contract position is ideal for a detail-oriented professional with a background in healthcare, business, or digital studies who thrives in a collaborative, fast-paced environment managing appeal and dispute adjudication programs.

Requirements

• Education: Bachelor's or advanced degree in healthcare, business, management, digital studies, or a related field.
• Experience: 2 years of collaborative project support is preferred; however, new graduates will be considered.
• Technical Skills:
• Knowledge and experience with collaborative project management software.
• Proficiency with electronic documents and design tools.
• Familiarity with commercial off-the-shelf and custom software applications for tracking and case management.
• Soft Skills:
• Excellent written and verbal communication skills, including professional phone manners.
• Strong problem-solving abilities with the capacity to work collaboratively with peers, medical staff, analytical teams, and administrative support.
• Ability to work independently with little supervision.
• Flexible, innovative, and creative mindset with strong multi-tasking abilities.
• Demonstrated ability to meet deadlines in a time-sensitive environment.

Responsibilities

• 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.

Benefits

• Competitive Compensation: Earn a competitive rate of $44 per hour.
• Work Schedule: Full-time position with a contract duration of at least 6 months.
• Professional Growth: Gain valuable experience in claims management, appeal adjudication, and collaborative project work within a mission-driven organization.
• Impactful Work: Contribute to a non-profit organization dedicated to improving healthcare processes and ensuring accurate claims adjudication that supports providers, patients, and healthcare plans.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level