Claims Payment Specialist
$66,300–$70,000 year
On-siteJericho, New York, United States
Job Summary
Review daily bank activity to identify incoming payments and match remittance information to maintain accurate records. Link payments to appropriate disputes and research transactions lacking documentation to identify related issues. Respond to inquiries regarding payment status, requirements, and refund requests from providers and health plans. Prepare daily transaction reports, bi-monthly closed-dispute reports, and refund requests with supporting documentation for approval. Maintain complete audit trails, documentation of issued checks and EFTs, and payor refund addresses while monitoring outstanding items and operational metrics. Support audits, process improvements, and reconciliation projects while meeting internal deadlines and CMS requirements.
Required Qualifications
- one (1) year of experience in financial operations, accounts receivable, payment processing, claims administration, or payment reconciliation
- two (2) years of experience in financial operations, accounts receivable, payment processing, claims administration, or payment reconciliation
Desired Qualifications
- Experience researching payment discrepancies, reconciling transactions, and maintaining financial records
- Advanced Microsoft Excel skills, including formulas, pivot tables, sorting, filtering, and data validation
- Experience using financial systems, databases, case management platforms, or CRM tools such as Salesforce
- Strong attention to detail and accuracy in a high-volume environment
- Excellent organizational and time-management skills with the ability to manage competing priorities
- Experience working with project management tools and electronic document systems
- Strong written and verbal communication skills
- Ability to work independently while collaborating effectively across departments
- Healthcare claims processing, payment reconciliation, or dispute resolution experience
- Strong problem-solving skills and the ability to work effectively with cross-functional teams
- Ability to adapt, multitask, and meet deadlines in a fast-paced environment
- Bachelor's degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field
- Associate degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field
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