OON Mandate Negotiation Analyst

Horizon Blue Cross Blue Shield of New Jersey(22 days ago)

Newark, NJOnsiteFull TimeMedior$55,286 - $73,404Claims

About this role

Manages resolution of inadvertent or involuntary out-of-network billing disputes between Horizon BCBSNJ and out-of-network health care professionals. Oversees end-to-end negotiation cases, ensuring compliance with state and federal regulatory timeframes and bringing cases to timely resolution. The role involves documentation, eligibility validation, research, and preparation of written adjudication justifications.

View Original Listing

Required Skills

Negotiation
Claims Processing
Eligibility Verification
Research
Communication
Customer Service
Conflict Resolution
Microsoft Office
Data Analysis
Time Management

Qualifications

High School Diploma/GED
Bachelor's Degree (Preferred)

About Horizon Blue Cross Blue Shield of New Jersey

horizonblue.com

Horizon BCBSNJ offers affordable New Jersey healthcare and health insurance for individuals, families and employers. Find cheap NJ health insurance quotes online from Horizon BCBSNJ website, an independent licensee of the BCBS Association.

View more jobs at Horizon Blue Cross Blue Shield of New Jersey →