(Remote – U.S. Only)
🧾 About the Role
Claritev is seeking a detail-driven, persistent, and results-oriented Claims Resolution Specialist to negotiate healthcare claim discounts with providers. You’ll play a key role in driving cost savings and strengthening Claritev’s mission to bend the cost curve in healthcare for all. This is a high-volume, phone-heavy role that combines negotiation, data tracking, and provider relationship management.
✅ Position Highlights
• Full-Time, Remote (W2)
• Salary: $20.32 per hour
• Eligible for 401(k), health insurance, bonuses, PTO, and more
• Must be authorized to work in the U.S.
• Job Requisition #: 11753
📋 What You’ll Own
• Contact healthcare providers to negotiate claim discounts before payment
• Review and analyze assigned claims, presenting compelling proposals to providers
• Perform provider research and apply phone-based negotiation tactics
• Maintain and update provider database with outcomes and preferences
• Address counteroffers and maintain accurate documentation
• Educate providers on available tools (e.g., online portals) to expedite negotiations
• Handle post-negotiation inquiries regarding payment status or terms
• Meet and exceed production and savings metrics
• Collaborate across departments to ensure smooth workflows
• Ensure HIPAA compliance at all times
🎯 Must-Have Traits
• High school diploma or GED (required)
• Minimum 6 months experience in healthcare, medical billing, insurance, collections, or managed care (1+ year preferred)
• Strong communication, negotiation, and objection-handling skills
• Comfort with high-volume outbound calls (up to 40% phone time)
• Basic math, attention to detail, and documentation accuracy
• Ability to work independently, manage time, and meet deadlines
• Proficient with MS Word, Excel, and database systems
• Licensure (e.g., NY Health Adjustor or P&C license) may be required, or must be obtained within 6 months if notified
💻 Remote Requirements
• Reliable internet and remote setup
• Comfortable working in a digital environment with phone, email, and EMR tools
• Must be able to sit and work at a monitor for extended periods
💡 Why It’s a Win for Healthcare Admin Pros
If you’re passionate about cost savings, negotiation, and improving the U.S. healthcare system from the inside out, this role gives you the opportunity to make a measurable impact while working from home.
✍️ Call to Action
Join Claritev and become part of a mission-driven team that values innovation, accountability, and diversity. Apply today and help shape a more affordable, accessible healthcare future.