Medical Claims Negotiation Specialist

Join a high-performing team dedicated to reducing healthcare costs by securing accurate and fair payments on medical claims. As a Medical Claims Negotiation Specialist, you'll play a crucial role in analyzing provider billing data, identifying errors, and negotiating reimbursements—directly influencing cost-containment outcomes and operational efficiency. Position: Medical Claims Negotiation Specialist Location: Fort Worth, TX | Remote (must reside locally) Pay: $19–$20/hour Direct Hire Schedule: Monday - Friday, 8am - 5pm JOB ID: 150517 KEY RESPONSIBILITIES Analyze billing histories and prior negotiations to determine a negotiation strategy Review internal reports and professional findings to validate billing errors Consult with clinical staff as needed to prepare for provider outreach Communicate with providers to present billing discrepancies and justify charge adjustments Negotiate corrections, fee removals, and adjusted payments on facility, professional, RX, and appeal/litigation claims Secure formal agreement through signed Letters of Agreement MINIMUM QUALIFICATIONS Must have previous fee negotiations, usual and customary fee schedules, or claims reimbursement experience. 3+ years’ experience in medical claims processing or PPO negotiation in managed care or benefits administration 2+ years of customer service experience in healthcare payer environments In-depth knowledge of Workers’ Compensation fee schedules and healthcare regulations Proven record of negotiating Group Health, Workers' Comp, Auto, and Liability claims Strong skills in EHR systems, medical coding basics, and healthcare terminology Prior work-from-home experience with a secure, private workspace Reliable high-speed internet (minimum 35 Mbps download/upload, no hotspot) CORE TOOLS & SYSTEMS Internal billing platforms Electronic Health Records (EHRs) Microsoft Office Suite PREFERRED SKILLS Experience resolving benefit payment disputes and first-level provider appeals Strong written and verbal communication abilities Detail-oriented with analytical and investigative strengths LEGAL NOTICE By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at: https://www.cornerstonestaffing.com/privacy #FW123 Apply tot his job Apply To this Job