Healthcare Claims Resolution Expert

1 day ago


Lahore, Punjab, Pakistan beBee Careers Full time

This role involves negotiating out-of-network reimbursement rates with providers, payers, and facilities. You will review and resolve billing disputes, underpayments, and denied claims.

Responsibilities:
  1. Negotiate reimbursement rates with providers, payers, and facilities.
  2. Resolve billing disputes, underpayments, and denied claims.
  3. Familiarize yourself with Texas Medicaid, Medicare, and commercial insurance policies.
  4. Communicate effectively with insurance companies, medical providers, and patients.
  5. Comply with Texas state regulations and payer policies.
  6. Analyze fee schedules, contracts, and reimbursement trends.
  7. Maintain accurate documentation and provide detailed reports.
Requirements:
  • At least 2 years of experience in out-of-network negotiations or medical claims resolution.
  • Texas-specific experience is essential.
  • Strong knowledge of medical billing, coding, and reimbursement methodologies.
  • Excellent negotiation, communication, and problem-solving skills.
  • Proficiency in Microsoft Office and claims management software.
  • Ability to work independently and manage multiple cases efficiently.


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