About this role

Negotiate out-of-network (OON) medical claims valued at $10,000 and above
Learn the negotiation role and understand (U&C) calculated rates and benchmarking of medical costs
Develop filing, naming conventions, and documentation processes
Conduct checklist workups and manage outbound communications via phone, fax, and email to facilitate negotiations
Work up and organize daily cases
Make outbound calls and develop provider contacts to understand production metrics

3-5 years of experience in a medical claim background
Demonstrated ability and strong understanding of benchmarking costs for medical services, supplies, and drugs
Previous medical provider/business office phone call handling history
Strengths in mathematical, written, and verbal skills.
Coding experience, CMS, and/or CPC Certification preferred
Proficient in Usual and Customary (calculations) and cost-benchmarking for drugs, supplies, and services.
Associate/High School graduate, or equivalent professional work experience

Negotiator Analyst, Level I

Key skills