Conduent Negotiation Specialist in Lakeland, Florida
Conduent is the world's largest provider of diversified business process services with leading capabilities in transaction processing, automation, analytics and constituent experience. We work with both government and commercial customers in assisting them to deliver quality services to the people they serve.
We manage interactions with patients and the insured for a significant portion of the U.S. healthcare industry. We are the customer interface for large segments of the technology industry and the operational and processing partner of choice for public transportation systems around the world.
Whether it's digital payments, claims processing, benefit administration, automated tolling, customer care or distributed learning - Conduent manages and modernizes these interactions to create value for both our clients and their constituents. Learn more at www.conduent.com .
Summary: The IQ Analysis Department reviews out of network bills to determine the reasonableness of each charge. The Specialist will negotiate with providers and facilities depending on state guidelines and regulations. Additionally, the Specialist is responsible for applying appropriate business rules to bills and applying Out of Network methodology when applicable. The Specialist is responsible for maintaining Turn Around Time (TAT), client specific instructions and manual application of discounts.
Essential Duties and Responsibilities
Negotiate discounts based on client direction, state guidelines and like services.
Ability to interpret reviewed bills and reason codes to determine if the bill is negotiable.
Effectively build and maintain relationships with providers and facilities to secure future discounts and/or long-term contracts.
Ability to effectively communicate and defend to providers and clients in writing and on the phone the basis for the methodology used to accomplish the reduction of charges.
Reviews department policies and procedures regularly.
Maintains a reference library of company and industry reimbursement policies.
Negotiates long-term provider discounts per client or Conduent book of business
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty completely and with ease. The specialist must have at least five years of claims experience. Experience should have encompassed a variety of reduction methodologies from different sources. Applicant must be willing to take on special projects and new assignments as needed. Applicant must have telephonic communication experience.
Education and/or Experience:
High school diploma
5 years healthcare experience
Comprehensive understanding of Internet, Windows interface, and software applications.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, sex, marital status, sexual orientation, physical or mental disability, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply or compete for employment with Conduent Business Services or one of its subsidiaries may request such accommodation(s) by sending an e-mail to accommodations@Conduent.com . Be sure to include your name, the job you are interested in, and the accommodation you are seeking. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the -Submit- button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form at https://downloads.conduent.com/content/usa/en/file/conduent-applicant-adaaa-referral-form.pdf .
Job Workforce Administration
Primary Location United States-Florida-Lakeland
Organization Financial Service Healthcare
Unposting Date Ongoing
Req ID: 18006656