Healthcare Claims & Provider Services Specialist II

Job Description

Job Description

Build on Your Healthcare Operations Experience

Green Light is a growing healthcare technology company that partners with healthcare providers and health plans to improve the healthcare claims and dispute-resolution process.

We're looking for an  experienced healthcare operations professional who can bring strong foundational skills to the role while continuing to develop their knowledge and expertise .

This role is a good fit for someone who is comfortable working with detailed information, managing multiple priorities, communicating with providers and other stakeholders, and working through issues that require careful review and follow-up. As you become familiar with the role, you'll have opportunities to take on increasingly complex responsibilities.

What You'll Do

• Review claims, case information, and supporting documentation
• Manage assigned cases and help move them from intake through resolution
• Identify discrepancies, missing information, and matters requiring follow-up or escalation
• Track deadlines, documentation, follow-ups, and case activity
• Support appeals, reimbursement matters, disputes, and case resolution
• Communicate professionally with providers, billing offices, health plans, clients, and internal teams
• Prepare case summaries, correspondence, and supporting documentation
• Research and apply policies, procedures, and applicable requirements
• Maintain accurate case records and confidential information
• Work through case issues thoughtfully, identify appropriate next steps, and seek guidance when needed
• Collaborate with internal teams to resolve issues and keep cases moving forward

As you develop your knowledge and experience, you may have opportunities to support more complex matters within the Provider Services team.

What We're Looking For

• Relevant experience in healthcare operations, health plans, payer operations, claims, provider services, reimbursement, appeals, customer service, legal support, or a related field
• Strong attention to detail and organizational skills
• Excellent written and verbal communication
• Ability to manage multiple cases, priorities, and deadlines
• Good judgment and a practical problem-solving approach
• Ability to learn and consistently apply detailed processes and requirements
• Comfortable researching and working through unfamiliar issues
• Proficiency with Microsoft Office and electronic recordkeeping tools
• Dependable, accountable, and willing to ask questions and seek guidance when needed
• Commitment to confidentiality and accurate documentation

Experience working on the  payer or health-plan side of healthcare operations is especially valuable. Experience with claims, reimbursement, appeals, provider relations, or related healthcare processes is also helpful.

Grow Your Expertise

If you're an experienced professional looking for an opportunity to build on your existing healthcare operations skills, develop specialized knowledge, and grow with a team that invests in developing talent from within , we'd love to hear from you.