Claims Specialist - Jericho, NY

Job description

Claims Specialist / Contract (#25322)

✔️ Location: Jericho, NY 11753
✔️ Employment Type: Full-time, Contract (minimum 6 months)
✔️ Hourly Rate: $44/hr

✅ Why Join Us
✔️ Competitive hourly rate of $44/hr
✔️ Full-time contract position with a minimum 6-month duration
✔️ Gain hands-on experience in healthcare claims, appeals, and dispute adjudication
✔️ Collaborate with peers, medical staff, and administrative teams in a mission-driven non-profit
✔️ Opportunity to grow your skills in case management, project tracking, and clinical review coordination

✅ Key Responsibilities
✔️ Serve as point-of-contact for appeal/dispute adjudication programs
✔️ Liaise with healthcare plans, providers, patients, and clients to coordinate requests and documentation
✔️ Monitor appeal/dispute status and client portal communications
✔️ Conduct eligibility reviews and recommend action plans to internal teams
✔️ Track and assign cases using specialized software applications
✔️ Review and provide documentation for billers, coders, nurses, physicians, and clinicians
✔️ Measure KPIs for timeliness, accuracy, and adherence to contract deliverables
✔️ Identify workflow barriers, recommend solutions, and implement approved improvements
✔️ Present case/project status in huddles, scrums, and team meetings
✔️ Prepare billing invoices and coordinate with Finance for payment tracking
✔️ Mentor and train new staff on case processes and workflow

✅ Qualifications
✔️ Bachelor's or advanced degree in healthcare, business, management, digital studies, or related field
✔️ 2 years of collaborative project support preferred; new graduates considered
✔️ Proficiency with project management tools, case management software, and electronic documents
✔️ Strong communication, problem-solving, multitasking, and independent work skills
✔️ Ability to meet deadlines in a fast-paced, collaborative environment