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About the Role

Greenlife Healthcare Staffing is seeking a Claims Specialist for a Non-profit organization in Jericho or Albany, NY. This role is ideal for a detail-oriented professional with a background in healthcare, business, or digital studies who thrives in a collaborative, fast-paced environment managing appeal and dispute adjudication programs.

Responsibilities

Act as point-of-contact for appeal/dispute adjudication programs.
Liaise with healthcare plans, providers, patients, and clients to coordinate requests, correspondence, and submission of case documentation.
Monitor appeal/dispute status and communication received on client portals.
Conduct initial eligibility reviews and recommend a course of action.
Track and assign cases using commercial off-the-shelf and custom software applications.
Review and provide case documentation to assigned billers/coders, nurses, physicians and clinicians internal teams, and key stakeholders for clinical and coding reviews.
Monitor and measure key performance indicators including timeliness, adherence to quality and accuracy standards, and deadlines for contract deliverables.
Identify barriers and roadblocks in work processes, recommend solutions, and execute approved solutions.
Present case/project status in huddles and scrums using an agile, iterative approach.
Schedule regular team status meetings and record decisions.
Prepare billing invoices, submit them to the Finance department, and liaise with accounting to track and trend payments.
Mentor and train new staff on process steps and case progression.
Perform other activities as may be deemed necessary.

Requirements

2 years of collaborative project support is preferred; however, new graduates will be considered.

Skills

Knowledge and experience with collaborative project management software, electronic documents, and design.
Familiarity with commercial off-the-shelf and custom software applications for tracking and case management.
Proficiency in Microsoft Office applications.
Ability to problem-solve and work collaboratively with peers, medical, analytical, and administrative support staff.
Excellent written and verbal skills, including phone manners.
Ability to work independently with little supervision.
Ability and desire to be flexible, innovative, and creative while multi-tasking.
Ability to meet deadlines in a time-sensitive environment.

Location

Jericho, NY
Albany, NY

Work Type

Full-time
Temporary/Contract
Monday to Friday

Experience Level

New graduates will be considered

Education Level

Bachelor's or advanced degree in healthcare, business, management, digital studies, or a related field.

Salary/Compensations

$44/hr

Benefits

1 Week of Paid Vacation
6 Major Paid Holidays per year
5 Sick Days (40 Hours) subject to the provisions of the NYS Paid Sick Leave Act
License Reimbursement after 1 year of employment
Health insurance subject to plan eligibility requirements
401k Matching eligibility after 1 year of employment
Benefits from Paychex, such as Payactiv

About the Company

Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities.
We partner with hospitals, clinics, nursing homes, multi-specialty groups, and private practices to match talented individuals with roles that align with their skills and career goals.
GLHS is a great company to work for with 93% retention of employees 2 years+, excellent Google reviews, and a strong company culture.