Hospital Claims Specialist

Description and Requirements

The Hospital Specialist is the point person responsible for ensuring maximization of operational efficiency between Healthfirst and our network hospitals.

Responsibilities:

• Managing day to day operational issues and concerns from hospital partners including but not limited to roster maintenance and claim issue root cause analysis
• Managing education/training regarding company-wide initiatives including but not limited to new product implementation, regulatory initiatives, and other various health plan business objectives
• Serving as an advocate for Hospital Providers within Healthfirst
• Work closely with numerous departmental partners, including operations, sales and finance

Minimum Requirements:

• Direct experience working with managed care operations and/or health plans
• Claims experience including root-cause analysis, system set-up, etc
• Strong communication skills (both verbal and written)
• Ability to work collaboratively, confidently and influentially various levels of staff and clients
• Excellent organizational skills
• Demonstrated ability to focus on the most tedious of details, while also being able to solve issues that are larger and more complex
• Ability to develop relationships and partner with external and internal business stakeholders
• Strong problem-solving skills
• Proficiency with Microsoft suite of applications

Preferred Qualifications:

• Bachelor's degree from an accredited institution

Hiring Range:

• Greater New York City Area (NY, NJ, CT residents): $57,400 - $78,030
• All Other Locations (within approved locations): $49,800 - $74,120

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.