NSA Claims Coordinator

The Phia Group is a service-oriented consultant that assists health plans nationwide, providing innovative cost-cutting solutions and service offerings to help employers identify reasonable healthcare prices while protecting employees against abusive practices like balance-billing.

About the role

The Provider Relations Coordinator will negotiate settlements with facilities and providers nationwide to reduce healthcare claims costs. This role serves as the point-person for the entire Provider Relations department and requires a proactive, persuasive, persistent, respectful, assertive, and multitasking professional.

Responsibilities

• Manage a daily running inventory of unpaid claims or claim disputes.
• Review and prioritize claims based on processing criteria, timelines, client demands, and service level standards.
• Contact facilities and providers to discuss charge adjustments and rationale.
• Explain benefits to resolve payment disputes with facilities.
• Draft correspondence pertaining to settlement and negotiation efforts for providers and other entities.
• Capture detailed notes on calls for future reference.
• Handle member inquiries in accordance with their medical plan as needed.
• Work with The Phia Group’s legal department to ensure escalation of claims.
• Participate in ongoing process improvement to develop efficiencies that streamline the claim settlement process.
• Properly handle confidential information in accordance with HIPAA.

Requirements

• Baccalaureate degree (BA/BS) from an accredited college or university.
• Minimum of two years of experience in a medical healthcare claims role, preferably involving negotiation, or experience at an insurance company, TPA, or hospital with emphasis in claims, fee schedules, or contracting.
• Computer literate, including proficiency in Microsoft Office products.

Working Conditions

• Sitting at a workstation for prolonged periods of time.
• Extensive computer work.
• Workstation may be exposed to overhead fluorescent lighting and air conditioning.
• Fast-paced work environment.
• Operates office equipment including personal computer, copiers, and fax machines.

Pay

$50,000 - $55,000

Benefits

The Phia Group offers unparalleled benefits and was named one of USA Today’s Top Workplaces for 2025. The company has also been recognized by The Boston Globe and Louisville Business First as a Top Place to Work in 2025 for its inclusive, enjoyable, and empathetic internal culture.