Description

The primary role of the Resolution Specialist is to resolve provider disputes for Fee Negotiation, Network, Multi-Service, and Bill Review & Audit claims, including renegotiating claims as needed. Individuals who succeed in this role will demonstrate excellent customer service skills, including strong verbal and written communication abilities. This position is responsible for metrics such as average time to resolve a dispute, average savings retention, frequency of dispute handling, and accurate documentation, all aimed at best servicing our clients and providers. Problem-solving skills will be essential for resolving issues with diplomacy and accuracy.

Company Culture and Environment

This company fosters a supportive and collaborative environment, encouraging team members to work closely across departments to deliver effective solutions. The focus on strong communication and customer service highlights a culture of respect and professionalism.

Career Growth and Development Opportunities

Those in this position will likely have the opportunity to develop their skills in dispute resolution and customer service, potentially leading to advancement within the company as they demonstrate success in handling complex claims and issues.

Detailed Benefits and Perks

While specific benefits are not detailed in the job description, the emphasis on delivering excellent service suggests a workplace that values employee satisfaction and client relationships, likely leading to a supportive benefits structure.

Compensation and Benefits

• Competitive salary based on experience
• Health, dental, and vision insurance
• Comprehensive retirement plan options
• Generous vacation and paid time off policy
• Flexible working arrangements

Why you should apply for this position today

This role offers a chance to make a meaningful impact by resolving provider disputes and enhancing client satisfaction. Joining this team means being part of a dynamic environment where strong communication and problem-solving skills are valued and rewarded.

Skills

• Excellent verbal and written communication skills
• Strong problem-solving abilities
• Ability to manage multiple tasks effectively
• Proficient in dispute resolution and negotiation techniques
• Familiarity with billing inquiries and claims management
• Attention to detail and accurate documentation practices

Responsibilities

• Research and resolve provider and client billing inquiries, renegotiating claims as necessary
• Maintain tracking of all necessary information related to assigned work
• Collaborate with internal teams to promptly resolve issues
• Assist department members with complex claims or escalated provider issues
• Communicate with clients for status updates and notifications of resolved issues
• Ensure adherence to HIPAA and Zelis standards regarding privacy
• Provide support for the Customer Care Team when needed
• Perform other related responsibilities as assigned

Qualifications

• Proven experience in a customer service or resolution specialist role
• Strong understanding of billing processes and dispute resolution
• Demonstrated ability to meet or exceed performance metrics
• Excellent interpersonal skills

Education Requirements

• High school diploma or equivalent required
• Associate or Bachelor’s degree in a relevant field preferred

Education Requirements Credential Category

• High School Diploma or equivalent
• Associate’s Degree preferred

Experience Requirements

• Minimum of 2 years in a similar role or relevant experience
• Experience in claims management or customer service preferred
• Familiarity with healthcare billing processes is a plus

Why work in Bedminster, NJ

Bedminster offers a beautiful suburban environment with excellent amenities and a strong sense of community. The area is known for its picturesque landscapes, providing an ideal backdrop for both work and leisure. With proximity to major metropolitan areas, you can enjoy the benefits of city life while residing in a peaceful setting.