Medicare: 1 year (Preferred)
We are seeking a Medical Claims Terms and Conditions Specialist to join a national Managed Services Organization (MSO) that ensure timely and accurate processing of medical claims. This MSO provides quality medical management support to clients, such as medical groups and Independent Physician Groups (IPAs).
The Terms and Conditions Specialist will establish provider contracting arrangements or benefits administration data elements in the existing application and other platform applications. Configuration will support the accurate & timely payment of claims. Terms and Conditions Specialist will test new releases, make enhancement recommendations, and evaluates contracts for configuration
The Specialist should clearly understand the products and healthcare benefits services offered to customers, including cost share, limits and regulatory rules and guidelines.
In this role, you will:
For this job, you need:
Job Type: Full-time
Pay: $23.00 - $26.00 per hour
Work Location: One location