Claims Specialist / Contract
1 day ago
Jericho
Job Description Claims Specialist / Contract - Jericho, NY (#25322) • Location:Jericho, NY, • Employment Type: Full-time, Contract (minimum 6 months), • Hourly Rate: $44/hr About Greenlife Healthcare Staffing: Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities. We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals. Position Overview: 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. Why Join Us? • 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. Key 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. Greenlife Healthcare Staffing - Empowering Healthcare Professionals, Enriching Lives Requirements Qualifications: • 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.