Health Insurance Stakeholder Specialist

A company is looking for a Health Insurance - Stakeholder Engagement Specialist. Key Responsibilities: Analyze and adjudicate payment determination disputes between nonparticipating providers and group health plans Manage stakeholder communications and ensure timely and accurate data entry into the government portal Complete case-related documentation and reporting for continuous quality improvement efforts Required Qualifications: Bachelor's degree; advanced degree in Health Care Administration or related field preferred At least 3 years of experience in Health Insurance Claim/Coverage issues Superior data entry skills and ability to thrive in a production-based environment Proficient in Microsoft Office Suite Ability to obtain and maintain U.S. Government Security Clearance

Mar 18, 2025 - 01:41

A company is looking for a Health Insurance - Stakeholder Engagement Specialist. Key Responsibilities: Analyze and adjudicate payment determination disputes between nonparticipating providers and group health plans Manage stakeholder communications and ensure timely and accurate data entry into the government portal Complete case-related documentation and reporting for continuous quality improvement efforts Required Qualifications: Bachelor's degree; advanced degree in Health Care Administration or related field preferred At least 3 years of experience in Health Insurance Claim/Coverage issues Superior data entry skills and ability to thrive in a production-based environment Proficient in Microsoft Office Suite Ability to obtain and maintain U.S. Government Security Clearance