Claims Repricing Coordinator

Role Overview

• Review and reprice medical claims using contracted provider network rates
• Apply appropriate discounts based on PPO, rental networks, and client agreements
• Validate billed charges against fee schedules and contract terms
• Identify pricing discrepancies and escalate issues when necessary
• Communicate with internal teams regarding claim status and pricing questions
• Maintain accurate documentation and notes within claims systems
• Meet productivity and accuracy standards
• Follow HIPAA and data privacy guidelines at all times

Requirements

• High school diploma or equivalent required; associate’s degree or coursework in healthcare, business, or related field a plus
• No prior healthcare or claims experience required (training provided)
• Strong attention to detail and accuracy
• Basic computer skills and comfort using multiple systems
• Ability to interpret contracts and follow written guidelines
• Good organizational and time-management skills
• Professional written and verbal communication skills

Benefits

• Comprehensive medical, dental, vision, and life insurance coverage
• 401(k) retirement plan with employer match
• Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
• Paid time off (PTO) and disability leave
• Employee Assistance Program (EAP)