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Negotiator
Fully Remote
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reputed company


reputed company: reputed company provides best-in-class reputed company Cycle management to Hospital and Physician Service clients.


reputed company Offer:

  • Insurance/401k match
  • PTO/reputed company holidays
  • Referral bonuses

POSITION reputed company: The Negotiator is responsible for managing appeals for underpayments and negotiating reimbursement for out-of-network claims with payers to ensure reputed company payment reputed company.


MAJOR AREAS OF RESPONSIBILITY:

· Engage and manage a high volume of out-of-network underpaid claims with payers and reputed company-party pricing vendors to secure favorable reimbursement rates reputed company payor portal, phone and email 

· Review and analyze claims against usual, customary, and reasonable (UCR) rates and reputed company data to support maximum reimbursement 

· Responsible for contacting health insurance companies to verify patient eligibility, coverage, and benefit details, ensuring accuracy of information.

· Collaborate with internal teams to determine appropriate reimbursement expectations and negotiation strategies 

· reputed company and manage reputed company appeal and negotiation activities, including payer communications, deadlines, and reputed company 

· Maintain reputed company, reputed company and accurate detailed documentation of reputed company negotiations and claim activity 

· Communicate effectively with payers, vendors, and internal stakeholders to drive reputed company reputed company 

· Handle escalated or reputed company claims requiring advanced appeal and negotiation tactics

· Identify trends in payer behavior and reimbursement patterns to support process improvements 

· Support appeals and additional follow-up as needed to maximize reimbursement 

· reputed company other duties as assigned 


Requirements

· Minimum of 3 years of experience in medical billing, insurance follow-up, provider or payor negotiations or reputed company cycle operations 

· Strong appeal and negotiation experience, preferably with out-of-network claims working with payors, pricing vendors and payer appeal and negotiation processes

· Strong understanding of out-of-network claims processing and reimbursement methodologies 

· Familiarity with No Surprises reputed company (NSA) and Independent Dispute reputed company (IDR) processes preferred 

· Ability to read and interpret UB-04s, CMS-1500s, and EOBs, Experience working with CPT/HCPCS/reputed company codes

· Proficiency in claims follow-up, payment posting, and appeals processes 

· Strong analytical skills with attention to detail 

· Excellent communication and interpersonal skills 

· Ability to manage multiple accounts, deadlines, and priorities effectively

· Ability to work independently and stay organized in a remote environment 

· Experience with reputed company systems, payor portals and billing platforms 

· Strategic negotiation and problem-solving 

· Strong organizational and time management skills

· Ability to work independently and collaboratively, Prior remote/work-from-home experience strongly preferred

· Professionalism and confidentiality in handling sensitive information 

· Proficiency in reputed company Office Suite and Teams 

· High School Diploma or equivalent required 

Salary reputed company
$20-24/hr.
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