Available Positions

Claims Specialist at Managed Long Term Care Organization in Bronx, New York, United States —

  • Healthcare
  • Managed Long Term Care Organization
  • Bronx, New York, United States
  • 10/17/20

Job ID: 1030117

Job Description

  • Long term care center in the Bronx looking for a full-time Claims Resolution Specialist to join their team as soon as possible
  • Responsibilities will include:
    • Train, develop, and assist claims staff to achieve successful job performance
    • Review claim staff on quality performance for procedural and financial accuracy
    • Analyze and evaluate existing procedures and make recommendations for change to enhance effectiveness, efficiency, and productivity
    • Assist in study of complex operational problems, new system requirements, and the effects of business, financial and regulatory changes
    • Assess needs of members, providers, governmental agencies, community organizations, staff members, and any other external or internal customer and determine best possible solution to their needs or issues
    • Assist claims department’s performance to meet or exceed claims processing standards for productivity and quality


6+ years’ experience in managed care, customer service, and claims processing required

Associates Degree or equivalent related experience required


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