What are the responsibilities and job description for the Claims Specialist (Contract to Hire) position at Alerion Healthcare?
Exciting Claims Specialist Opportunity!
Location : Bronx, NY
Schedule : 40 hours per week – 2 days in-office, 3 days remote
Compensation : $27 - $30 per hour (Depending on Experience)
Benefits :
Comprehensive medical benefits
401(k) with company match
Paid time off
Work-life balance with hybrid work schedule
Career growth opportunities
A supportive, dynamic team environment
Why This Role is Perfect for You :
Are you looking to take your career in healthcare claims management to the next level? This Claims Specialist position offers the perfect balance of challenge, growth, and flexibility. You’ll enjoy the opportunity to work remotely for 3 days a week while still collaborating with a team in the Bronx for 2 days in-office.
With competitive pay, excellent benefits, and a chance to make a real impact, this is your opportunity to thrive in a role where your expertise is valued and your contributions are recognized.
Perks & Benefits You’ll Love :
Flexibility : A hybrid work schedule gives you the freedom to work remotely 3 days a week.
Comprehensive Benefits : Health coverage, 401(k) with company match, and paid time off.
Career Growth : Take on meaningful work and advance your skills with a clear path for professional development.
What You’ll Do :
As a Claims Specialist , you will :
Manage claims processing : Review claims, resolve provider disputes, and perform root cause analysis to identify areas for improvement in claims workflows.
Collaborate and communicate : Work closely with providers, vendors, attorneys, and other stakeholders to ensure claims are processed in compliance with contractual and regulatory guidelines.
Analyze and improve : Generate detailed reports, identify trends, and suggest process enhancements to improve claims accuracy and reduce errors.
Educate and guide : Assist providers with billing procedures and coverage guidelines while helping to configure compensation grids for reimbursement.
Lead the charge : Provide feedback on system configurations, claim workflows, and improve processes to prevent future issues and enhance efficiency.
What We’re Looking for :
We’re seeking a professional with the following qualifications :
Experience : 8 years in insurance or healthcare, with a focus on claims adjudication and experience in Medicaid / MLTC and managed care.
Skills : Strong proficiency in MS Excel, Word, PowerPoint, and experience with claims processing systems.
Knowledge : Familiarity with CPT, ICD, DRG, and other healthcare coding systems.
Education : A Bachelor’s degree is required. Additional certifications like Certified Professional Coder (CPC) are a plus.
Problem-Solving : You’re detail-oriented and an effective communicator who can handle complex claims-related issues and drive solutions.
Ready to Take the Next Step?
If you're eager to join a dynamic team where your expertise will be valued, apply now! This is an incredible opportunity to bring your healthcare claims experience to a role where you can make a tangible impact.
Salary : $27 - $30
