Healthcare Claims & Provider Services Specialist II
Green Light Cost Management•Scottsdale, AZ
•$25 - $33
About The Position
About Green Light Green Light is a growing healthcare technology company that partners with healthcare providers and health plans to improve the healthcare claims and dispute-resolution process. We're looking for an experienced healthcare operations professional who can independently manage claims and provider-service matters and help move complex cases toward resolution.
Requirements
- Relevant experience in healthcare claims, provider services, reimbursement, appeals, dispute resolution, legal support, or a related field
- Strong attention to detail and organizational skills
- Excellent written and verbal communication
- Ability to independently manage multiple cases, priorities, and deadlines
- Strong judgment and problem-solving skills
- Ability to learn and consistently apply detailed processes and requirements
- Comfortable using Microsoft Office and electronic recordkeeping tools
- Dependable, accountable, and comfortable taking ownership
- Commitment to confidentiality
Nice To Haves
- Experience with the No Surprises Act, IDR, Open Negotiations, healthcare reimbursement, claims/appeals, provider negotiations, or regulatory matters is especially valuable.
Responsibilities
- Review claims, case information, and supporting documentation
- Manage cases from intake through resolution
- Identify discrepancies, missing information, and escalation needs
- Track deadlines, documentation, follow-ups, and case activity
- Support appeals, reimbursement disputes, negotiations, and complex case resolution
- Communicate with providers, billing offices, health plans, clients, and internal teams
- Prepare case summaries, correspondence, and supporting documentation
- Research and apply policies, procedures, and regulatory requirements
- Maintain accurate case records and confidential information
- Take ownership of complex cases and determine appropriate next steps
- Support IDR, Open Negotiations, No Surprises Act workflows, grievances and appeals, provider or payer negotiations, and regulatory matters.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
