
Out-of-Network Negotiation Specialist
2 days ago
Expert Reimbursement Specialist
We are seeking an experienced professional to join our team as a skilled out-of-network negotiator and corresponding resource.
About the Role:- Negotiate reimbursement rates with providers, payers, and facilities.
- Review and resolve billing disputes, underpayments, and denied claims.
- Familiarity with Texas Medicaid, Medicare, and commercial insurance policies is essential.
- Communicate effectively with insurance companies, medical providers, and patients.
- Maintain accurate documentation and provide detailed reports.
- Minimum 2 years of experience in out-of-network negotiations or medical claims resolution.
- Texas-specific experience (knowledge of local payers, regulations, and billing practices) is highly valued.
- Strong understanding of medical billing, coding (CPT, ICD-10), and reimbursement methodologies.
- Excellent negotiation, communication, and problem-solving skills are required.
- Proficiency in Microsoft Office and claims management software is necessary.
- Ability to work independently and manage multiple cases efficiently.
- Seniority level: Entry level
- Employment type: Full-time
- Job function: Accounting/Auditing and Finance
- Industries: Healthcare
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