If you’re looking for a remote work from home job in the healthcare industry, the Claims Resolution Specialist position at Claritev might be a great fit.
This role offers a mix of customer service, negotiation, and data handling all from the comfort of your home. Let’s break down what this job is all about, what skills you need, and what benefits you’ll receive.
Claims Resolution Specialist at Claritev
The main job of a Claims Resolution Specialist is to contact healthcare providers and negotiate discounts on medical claims before they are paid.
This helps insurance companies and clients save money. You’ll be working with a high volume of claims, so being organized and focused is important.
Here are some key tasks:
- Review and manage healthcare claims to find savings opportunities.
- Call providers to discuss payment proposals and negotiate better rates.
- Handle counteroffers and try to reach fair agreements.
- Update provider information for future claims.
- Educate providers about online tools for reviewing proposals.
- Respond to questions after claims are closed, including payment status.
- About 40% of your time will be spent on phone calls, so good communication skills are a must.
Skills and Experience Needed
To apply for this job, you need at least a high school diploma or GED. You should also have some experience in the healthcare field like billing, coding, collections, or insurance. One year of experience is preferred, but six months is the minimum.
Other important skills include:
- Strong verbal and written communication.
- Ability to follow instructions and stay professional on calls.
- Good math skills and attention to detail.
- Ability to work independently and handle confidential information.
- Familiarity with Microsoft Word and Excel.
In some cases, you may need a state license, especially if you’re working with auto or workers’ compensation claims. If you don’t have the license, you’ll need to get it within six months of starting the job.
Work Environment and Expectations
This is a remote job, so you’ll need a quiet space to work and reliable internet. You’ll be sitting and working on a computer for long periods, using tools like phones, keyboards, and office software.
The job involves working with sensitive health data, so you must follow HIPAA rules and keep information private. You’ll also need to meet performance goals and handle a large number of claims each day.
Pay and Benefits
The starting pay is $20.23 per hour. Your exact offer may depend on your experience, skills, and location. In addition to your salary, Claritev offers a strong benefits package:
- Health, dental, and vision insurance with low costs.
- Life insurance and disability coverage.
- Paid parental leave.
- 401(k) with company match.
- Employee stock purchase plan.
- Paid time off that increases with years of service.
- 10 paid holidays.
- Tuition reimbursement.
- Flexible spending accounts.
- Employee assistance program.
- Sick leave (1 hour for every 30 hours worked, up to 40 hours per year).
- Claritev also offers flexible schedules and professional development programs to help you grow in your career.
Company Culture
Claritev values innovation, accountability, and diversity. They aim to improve healthcare costs and provide excellent service to clients and employees. The company encourages bold ideas and teamwork, making it a supportive place to work.
They are an Equal Opportunity Employer, which means they welcome applicants from all backgrounds and do not discriminate based on age, race, gender, or other factors.
Final Thoughts
The Claims Resolution Specialist role at Claritev is ideal for someone who enjoys working with data, talking to people, and solving problems.
It’s a fast-paced job with clear goals and good benefits. If you have some healthcare experience and want a remote position with growth opportunities, this could be a great match.
Applications are accepted for at least five days after the job is posted, so don’t wait too long to apply!
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