What are the responsibilities and job description for the Health Care Claims Negotiator position at Health Payer Consortium?
Location: Maryland Heights or remote
Employment Type: Full-Time
About Us:
HPC is an industry-leading company that has been thriving for over 10 years. With our remarkable growth—doubling in size each year—we are expanding our team and seeking a dedicated Negotiator to join us.
Our business is correcting healthcare claims by removing billing errors and other mistakes. We perform this cost containment function for employer based health plans who “self-Insure”. This means we help thousands of small companies to offer health insurance to their employees.
Our culture is fun, creative, and collaborative, making HPC not just a workplace, but a community where your contributions are valued. We are driven by a unique blend of technology and human talent. First and foremost we are business professionals and as a side note, many of us happen to be professional, semi professional or amateur entertainers and musicians. Your fellow co-workers will be physicians, case managers, negotiators, nurses, industry veterans, healthcare attorneys. Join our dynamic team and contribute to a mission of driving impactful cost savings and superior client outcomes.
Copy and paste to a browser and you can see us in our natural environment.
https://www.youtube.com/@healthpayerconsortium
https://www.healthpayerconsortium.com/
Position Summary:
The Health Care Claims Negotiator is responsible for negotiating medical claims and reimbursement rates between health care providers and payers. The ideal candidate has a strong background in health care, insurance, or claims management and excels at building relationships, resolving disputes, and analyzing claims data.
Key Responsibilities:
- Review, analyze, and negotiate healthcare claims to achieve fair resolutions for all parties involved.
- Collaborate with providers, payers, and third-party administrators to resolve outstanding claims efficiently.
- Maintain compliance with state and federal regulations, as well as HPC policies.
- Utilize negotiation strategies to secure cost-effective claim settlements.
- Manage a portfolio of claims, tracking progress and ensuring timely resolution.
- Generate and analyze reports to monitor claim outcomes and identify opportunities for improvement.
- Maintain accurate and detailed records of all negotiation activities.
Qualifications:
- Bachelor's degree in healthcare management, business administration, or verifiable experience negotiating provider contracts and individual claims.
- An understanding of how to use billing errors and other mistakes on claims to settle claims or negotiate ongoing provider contracts.
- Proven experience in claims management, negotiation, or health insurance.
- In-depth knowledge of healthcare billing, coding, and reimbursement methodologies.
- Excellent communication, negotiation, and problem-solving skills.
- Proficient in Microsoft Office Suite and claims management systems.
- Strong analytical and organizational abilities with attention to detail.
- Ability to work independently and collaboratively in a fast-paced environment.
Job Type: Full-time
Pay: $60,000.00 - $80,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: Hybrid remote in St. Louis, MO 63146
Salary : $60,000 - $80,000