Nurse Negotiator

About Carisk Partners, Inc. Carisk Partners, a Best Places to Work award winning organization, is a specialty risk transfer, care-coordination company servicing insurers, government entities, self-insured plan sponsors and other managed care organizations. Through its Pathways 2 Recovery care model, Carisk Partners aims to improve outcomes and reduce overall cost of quality care by applying best practices in a patient – centered approach to manage complex challenges for the group health, casualty and auto markets. Role Overview The Medical Bill Negotiator role establishes contact with providers to negotiate savings on medical bills or pre or post service date. Working with the Bill Review analysis team, Negotiator will apply proper jurisdictional regulations, reductions etc. to the bill to establish a baseline from which negotiations will be calculated. Negotiator will contact the providers using any available means (phone, fax, email etc.) in order to negotiate savings below the established baseline using proprietary metrics, historical results and other strategies as needed. The Negotiator then completes the appropriate reimbursement agreement and documents savings for clients. Role Responsibilities Determines cost saving opportunities and pricing optimization strategies. Reviews and analyzes EORs (Explanation of Reimbursement), medical bills and medical records. Completes negotiation tasks timely with respect to Client deadlines, Jurisdictional Due Dates. Enables a positive, effective relationship with the provider through phone calls and email communication while meeting client expectations. Obtains signed agreements from providers and document savings on medical bills. Maintains updated provider demographics, negotiation progress notes and successful outcomes in Open Claims log. Responds to customer questions regarding treatment and billing. Participates in planning, weekly meetings, and backlog sessions. Performs other duties as assigned by supervisors and managers. Complies with all company guidelines, code of conduct, policies, and standards. Role Qualifications Current RN, BSN, CPC Certification a must Minimum 3 years nursing experience. Strong working knowledge of Microsoft Office 365 and Excel Strong communication skills, including the ability to respond to others professionally and in a timely manner. Must be able to work independently and possess the ability to develop and maintain constructive and cooperative working relationships. Strong attention to detail, with a high level of accuracy and problem-solving skills. Requires strong organizational skills with proven capacity to handle multiple priorities. Requires high level of skill in verbal and written communication, customer service, and effective telephone communication. Culture and Benefits at Carisk: 10.5 Paid Company Holidays Paid Time Off Competitive Medical, Dental, and Vision Insurance Company Sponsored Life Insurance Supplemental Life Insurance, Short/Long Term Disability, Employee Assistance Program, Flexible Spending Account, and many other Ancillary Benefits 401(k) Retirement Plan with Company Match ClassPass Wellness Program Employee Discount Program Flexible and Hybrid Schedule Options* Internal Education Programs and Tuition Reimbursement Options Internal Advancement Opportunities Company-Wide Diversity and Holiday Celebrations Best Places to Work Award Recipient 6 years in a row! *Schedule options and work location vary between departments and management approval Carisk Partners provides equal employment opportunities to all employees and applicants for employment, and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.