Specialist, Contingency Support

Temporary Medical Claims Intake Coordinator

$17 / hour Mon- Fri

This role manages an arbitration case load including evaluation of provider disputes and appropriate client payment offers. The incumbent will coordinate efforts with the team and leadership to bring matters to efficient and successful outcomes. The incumbent's primary responsibility will be responding to oversee and manage the intake, processing and cooridination of all materials and information relating Independent Dispute Resolution ("IDR") as regulated by Federal or state law.

• Prepare written analyses of disputed provider/health plan positions and persuasively document arguments supporting client positions in arbitration packages pursuant to federal regulations.

• Conduct due diligence (e.g. online research, portal and application research) to assist with the analysis and preparation of arbitration packages.

• Works with other departments to develop or obtain information necessary for the submission of IDR packages.

• Review and analyze clinical information along with documents submitted by providers of moderate to high complexity.

• Meet federal filing deadlines and turn around times

• Respond timely to all electronic, written and verbal communications, log information derived from written and verbal communication; maintain detailed and accurate records.

• Outreach to clients for data needed for arbitration packages

• Maintain department productivity and quality standards

• Sensitivity to privacy in accordance with HIPAA guidelines

• Collaborate, coordinate, and communicate across disciplines and departments.

• Ensure compliance with HIPAA regulations and requirements.

• Demonstrate Company's Core Competencies and values held within.

• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

Required Qualifications

• Minimum high school diploma or G.E.D.
• Minimum 2 years customer service or provider communication experience (preferably within the health care industry) including direct experience working with provider data, reimbursement methodology and provider communication.
• Knowledge of medical codes, negotiations and contract terminology preferred
• Communication (written, verbal and listening), negotiation, organization and time management skills
• Ability to use software, hardware and peripherals related to job responsibilities, including MS Office
• Ability to establish priorities when faced with multiple, critical task

The salary for this position is $17/per hour.

Actual compensation is based on experience, skills, education, work location, and internal equity. This position may also be eligible for incentive compensation and the comprehensive benefits outlined in the My Total Value section.

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Why Claritev?

Healthcare is complex. We help make it clearer.

At Claritev, you'll do work that matters. Together, we're helping make healthcare more transparent and affordable for all through the power of data, technology, and expertise. We offer meaningful opportunities to grow your career, collaborate with talented colleagues, and make an impact on the clients and communities we serve. If you're looking for purpose, growth, and a team that succeeds together, you'll find it here.

What Guides Us

At Claritev, innovation, agility, and a focus on results drive our success. We embrace bold thinking, work as one team, take ownership, and strive for excellence in everything we do - creating meaningful impact for our clients, communities, and each other.