Kelly Services Kelly Services is seeking Permanent Insurance Investigator Medical Claims clerks in Braintree, Massachusetts

Job Description

Kelly Services is seeking Permanent Insurance Investigator Medical Claims Settlement Specialists at a Top Organization in Braintree!

Summary of Position: To negotiate settlement with facilities and providers on a national basis to reduce healthcare claims cost. The ideal candidate is an experienced claims negotiator and is highly skilled in working with facilities, physicians, ambulatory surgical centers and helping guide patients relating to claims issues. The candidate should be familiar with CMS-1450 and CMS-1500 forms, all the data elements, and comfortable with claim benchmarks like Medicare and costs. This position requires someone that is self-motivated, proactive, persuasive, persistent, respectful, and assertive. The candidate must be comfortable multi-tasking and possess strong communication skills, both oral and written.

ROLES AND RESPONSIBILITIES:

  • Manage a daily running inventory of unpaid claims or claim disputes

  • Review and prioritize claims based on processing criteria, timelines, client demands, service

level standards, etc.

  • Review claims and plan language and determine the best way to engage the healthcare provider

  • Contact facilities and providers to discuss charge adjustments and rationale while obtaining

  • Signed, agreements for reimbursement

  • Contact facilities and explain benefits to resolve payment disputes

  • Work with legal department to ensure escalation of claims

  • Participate in on-going process improvement to develop efficiencies that streamline the claim

  • Settlement

  • Ability to properly handle confidential information in accordance with the Health

REQUIRED QUALIFICATIONS:

  • Preferred: Baccalaureate degree (BA/BS) from an accredited college or university.

  • Preferred: Minimum of three years' experience in a medical healthcare claims role dealing with

  • Facilities, providers and members is required.

  • Background in healthcare claims management environment including provider negotiation,

  • Hospital billing, claims adjudication and administration or the ability to interpret benefit plans.

  • Two year(s) minimum insurance company/TPA/hospital experiences, with emphasis in Claims, fee schedules, contracting, and/or external vendor relationship management preferred

  • PC literate, including Microsoft Office products and web based application

Please send resumes to 3219@kellyservices.com for consideration

Why Kelly ® ?

At Kelly Services ® , we work with the best. Our clients include 95 of the Fortune 100 ™ companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.

AboutKelly Services ®

As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people around the world and have a role in connecting thousands more with work through our global network of talent suppliers and partners. Revenue in 2016 was $5.3 billion. Visit kellyservices.com and connect with us on Facebook , LinkedIn and Twitter .

Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females, Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is committed to employing a diverse workforce. Equal Employment Opportunity is The Law. at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm