Claims Specialist / Contract

Greenlife Healthcare Staffing • Albany, NY

3d

About The Position

Greenlife Healthcare Staffing is seeking a Claims Specialist for a temporary/contract assignment with a nonprofit organization in Jericho or Albany, New York. The role supports appeal and dispute adjudication programs in a collaborative, fast-paced environment. The specialist coordinates requests and case documentation among healthcare plans, providers, patients, clients, and internal clinical and administrative teams; monitors cases and performance measures; and supports process improvement, invoicing, and staff training. The position is full-time, Monday to Friday, at an hourly rate of $44.

Requirements

• Bachelor's or advanced degree in healthcare, business, management, digital studies, or a related field.
• Ability to problem-solve and work collaboratively with peers and medical, analytical, and administrative support staff.
• Excellent written and verbal communication skills, including phone manners.
• Ability to work independently with little supervision.
• Ability and desire to be flexible, innovative, and creative while multitasking.
• Ability to meet deadlines in a time-sensitive environment.
• Proficiency in Microsoft Office applications.
• Knowledge and experience with collaborative project management software, electronic documents, and design.
• Familiarity with commercial off-the-shelf and custom software applications for tracking and case management.

Nice To Haves

• Two years of collaborative project support experience is preferred; new graduates will be considered.

Responsibilities

• Act as the point of contact for appeal and dispute adjudication programs.
• Coordinate requests, correspondence, and case documentation with healthcare plans, providers, patients, and clients.
• Monitor appeal and dispute status and communications received through client portals.
• Conduct initial eligibility reviews and recommend a course of action to the 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, clinicians, and key stakeholders to facilitate clinical and coding reviews.
• Monitor key performance indicators, including timeliness, quality and accuracy standards, and contract deliverable deadlines.
• Identify work-process barriers, recommend solutions, and implement approved solutions.
• Present case and project status in huddles and scrums using an agile, iterative approach to implementation and data presentation.
• Schedule regular team status meetings and record decisions, assigned tasks, and next steps.
• Prepare billing invoices at case completion, submit them to Finance, and liaise with Accounting to track and trend payments.
• Mentor and train new staff on process steps and case progression.
• Perform other activities as necessary.

Benefits

• One week of paid vacation.
• Six major paid holidays per year.
• Five sick days (40 hours), subject to the provisions of the NYS Paid Sick Leave Act.
• License reimbursement after one year of employment.
• Health insurance, subject to plan eligibility requirements.
• 401(k) matching eligibility after one year of employment.
• Benefits from Paychex, such as Payactiv.

What This Job Offers

• Job Type: Full-time