Claims Negotiator

We are looking for a detail-oriented individual to support claims negotiation activities within the health insurance space for a contract position. This role focuses on coordinating with healthcare providers to establish reimbursement arrangements for out-of-network services while ensuring each case progresses accurately and efficiently. The ideal candidate brings strong written and verbal communication, sound judgment, and the ability to manage multiple priorities in a fast-paced remote environment.

Responsibilities:

• Evaluate incoming case assignments, interpret referral details, and determine the appropriate next steps for negotiation activity.

• Contact healthcare providers to discuss case specifics, gather needed information, and build productive working relationships throughout the process.

• Lead conversations to secure acceptable reimbursement terms and complete single-case or comparable payment agreements when needed.

• Prepare, revise, and track Letters of Agreement to ensure terms are clearly documented and processed in a timely manner.

• Keep providers and internal stakeholders informed on case progress from initial outreach through final resolution.

• Conduct quality checks on case documentation and agreement details to confirm accuracy, completeness, and adherence to standards.

• Coordinate required authorizations, approvals, and signatures so agreements can be finalized without unnecessary delay.

• Record case activity thoroughly and maintain organized files that reflect current status, negotiated terms, and supporting documentation.

• Follow established workflows, compliance expectations, and procedural guidelines while advancing cases toward closure.

• Distribute completed agreements, confirm final processing steps, and close cases once all documentation requirements have been satisfied.

Qualifications:

• Experience working with healthcare providers in a detail-oriented service, claims, or reimbursement-related setting.
• Ability to perform effectively in a high-volume environment with demanding turnaround expectations.
• Strong attention to detail with proven skills in organization, prioritization, and time management.
• Confidence following structured processes and applying complex operational or compliance guidelines accurately.
• Clear verbal and written communication skills, including the ability to draft clear correspondence.
• Background in claims negotiation, provider contracting, or single-case agreement work is preferred.
• Familiarity with reviewing agreement language and maintaining positive provider relationships is highly valued.

Compensation

$26.00-$30.00 Hourly

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