Network Contracting Consultant
2 days ago
Job Title: Medical Claims Negotiator
Job Summary:
- We are seeking a skilled Medical Claims Negotiator to join our team at HR Studio Ltd.
Key Responsibilities:
- Initiate contact with out-of-network provider offices to negotiate fees and rates
- Manage requests from a designated queue and accurately perform data entry and documentation related to the repricing of medical claims
- Communicate with providers through various channels and diligently record all interactions and progress
- Oversee the claims process to ensure timely and accurate adjudication
- Process out-of-network claims efficiently and in accordance with established guidelines
- Maintain up-to-date communications to provide timely responses and support within the assigned turnaround time
Requirements:
- Matric Diploma or Equivalent and 1 year of provider contracting, data or network administration experience in a healthcare third party administrator setting or 2 years of claims processing or customer service experience in a medical/healthcare setting
- Prior work in production environment
- Ability to maintain confidentiality and exercise discretion in handling sensitive information
- Proficiency in Microsoft Office
Working Hours: 2pm - 11pm
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