Claims Repricing Coordinator
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Job Description
Claims Repricing Coordinator reviewing medical claims and applying network discounts. Focused on pricing accuracy based on client contracts with attention to detail and documentation.
Responsibilities:
- Review and reprice medical claims using contracted provider network rates
- Apply appropriate discounts based on PPO, rental networks, and client agreements
- Validate billed charges against fee schedules and contract terms
- Identify pricing discrepancies and escalate issues when necessary
- Communicate with internal teams regarding claim status and pricing questions
- Maintain accurate documentation and notes within claims systems
- Meet productivity and accuracy standards
- Follow HIPAA and data privacy guidelines at all times
Requirements:
- High school diploma or equivalent required; associate’s degree or coursework in healthcare, business, or related field a plus
- No prior healthcare or claims experience required (training provided)
- Strong attention to detail and accuracy
- Basic computer skills and comfort using multiple systems
- Ability to interpret contracts and follow written guidelines
- Good organizational and time-management skills
- Professional written and verbal communication skills
Benefits:
- Comprehensive medical, dental, vision, and life insurance coverage
- 401(k) retirement plan with employer match
- Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
- Paid time off (PTO) and disability leave
- Employee Assistance Program (EAP)
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