Negotiator I

Job Details

Description

The Negotiator is responsible for obtaining negotiated discounts on facility and provider bills.

The is a remote position.

Essential Functions & Responsibilities

• Review previous negotiation and/or billing history of the provider
• Review LIBR and Professional Review findings
• Determine approach and the target contact within the provider organization; based on review findings and previous history
• Consult with Nurse Reviewer and clarify as needed
• Contact provider to discuss findings at the appropriate level
• Present errors, non-compensable fees and overcharges
• Negotiate removal of all errors and non-compensable fees
• Negotiate adjustment of remaining charges
• Secure signed Letter of Agreement
  
  

Knowledge & Skills

• Excellent written and verbal communication skills
• Medical terminology and coding knowledge
• Experience handling benefit payment disputes and/or first level provider appeals
  
  

Education & Experience

• 3+ years of medical claims processing and/or PPO negotiation experience in the Managed Care and Benefit Administration industries
• 2+ years of customer service experience working in the Managed Care and Benefit Administration industries
• Extensive knowledge of Workers Compensation fee schedules and regulations
• Experienced in successful negotiation of Group Health, Workers Compensation, Auto and General Liability claims
  
  

Pay Range

CorVel uses a market based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.

For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.

Pay Range: $18.80 - $30.34 per hour

A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management

In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.

About CERIS

CERIS, a division of CorVel Corporation, a certified Great Place to Work® Company, offers incremental value, experience, and a sincere dedication to our valued partners. Through our clinical expertise and cost containment solutions, we are committed to accuracy and transparency in healthcare payments. We are a stable and growing company with a strong, supportive culture along with plenty of career advancement opportunities. We embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.

CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.