Help shape the future of healthcare cost management. Claritev is hiring a Medical Claims Resolution Specialist II to join their growing team of innovators dedicated to bending the cost curve in healthcare while delivering exceptional service and savings to clients and providers.
About Claritev
Claritev is a leading technology and data-driven healthcare organization focused on improving financial efficiency and transparency across the medical system. Rooted in innovation, accountability, and diversity, Claritev empowers teams to push boundaries and drive meaningful transformation within the industry.
Schedule
Full-time, remote position within the United States. Standard business hours with flexibility to manage claim queues and provider communications.
What You’ll Do
- Research and negotiate healthcare claims with providers to secure maximum savings.
- Communicate effectively via phone and written correspondence to reach agreements.
- Address counteroffers and seek opportunities to improve provider negotiations.
- Maintain up-to-date claim actions and meet strict client deadlines.
- Collaborate across teams including Account Management, Provider Services, and Customer Relations.
- Ensure HIPAA compliance and handle confidential data responsibly.
- Meet performance metrics and participate in process improvement initiatives.
What You Need
- High school diploma or GED required.
- 2+ years of experience in healthcare, insurance, provider billing, or managed care.
- Knowledge of medical coding systems (CPT, ICD-9/10, revenue codes) preferred.
- Strong verbal, written, and negotiation skills.
- Proficiency with MS Office and database systems.
- Ability to manage multiple clients, prioritize deadlines, and maintain accuracy in a fast-paced environment.
- State adjuster licensure (NY Health and/or P&C) may be required; must be obtained within six months if not already held.
Benefits
- Competitive hourly rate starting at $21.12.
- Health, dental, and vision coverage with low deductibles.
- 401(k) with company match and Employee Stock Purchase Plan.
- Generous Paid Time Off and 10 paid holidays.
- Life insurance, short and long-term disability, and paid parental leave.
- Tuition reimbursement and professional development opportunities.
- Employee Assistance Program and flexible spending accounts.
Join a team that’s bold, collaborative, and focused on transforming healthcare through innovation and service excellence.
Happy Hunting,
~Two Chicks…