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Claims and Reconsideration Specialist
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Claims and Reconsideration Specialist

Job Snapshot

Employment Type Full-Time
Job Type Health Care
Education Not Specified
Experience Not Specified
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified

Job Description

Prime Health Services, Inc. (PHS) one of the leading Workers’ Compensation, Group Health, and Auto Liability PPO companies in the Southeastern US is growing rapidly across the country! Our Repricing and Reconsideration Department is seeking candidates who want to join our exciting company based in beautiful Brentwood, Tennessee, a suburb of Nashville.

This position is responsible for communicating with providers and clients who have disputed the outcome of their PPO discount.  This position acts as a liaison between the provider, the client and any Prime Health network partners to resolve medical bill disputes.  This person will also be responsible for entering medical bills into Prime Health’s repricing system to generate an Explanation of Benefits 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.

 



Job Requirements



Excellent written and oral communications skills, flexibility, adaptability, problem solving capability, creativity, initiative, teamwork skills, prioritization skills, public relations and customer service skills are required. Handle high pressure situations, in a professional manner. Strong technical skills required, including MS Office. Training will be provided to qualified candidate.

 

Bachelor’s degree or history of experience in the bill review or claims repricing field is preferred.  Compensation package for this position includes a full package of benefits.  Get your career start with an excellent growing healthcare company.

Our employees make a difference in the lives of many through our healthcare services!  If you are qualified, we are interested in talking with you. Please forward cover letter, resume, job salary history, and references to PHS. No candidate will be considered without verifiable job salary history.   


 



 

  

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Claims and Reconsideration Specialist


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