{"id":1713771,"url":"https://alion.io/job/ipro-claims-specialist","title":"Claims Specialist","company":{"id":2162026,"name":"IPRO","domain":"ipro.org","url":"https://alion.io/company/ipro-org","size_band":"201-500","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"ADP","truth_index":{"grade":"C","score":69,"open_postings":21,"ghost_share":0.524,"stale_share":0,"repost_share":0,"time_to_fill_p50_days":null,"computed_at":"2026-11-03T05:54:40Z"}},"role":"Finance","role_family":"Finance","seniority":"junior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Jericho, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":66300,"max":70000,"currency":"USD","period":"year","gross":null,"usd_annual":70000},"salary_estimate":null,"experience_years_min":1,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Agile","optional":false}],"status":"closed","first_seen_at":"2026-02-27T16:48:00Z","employer_posted_date":"2026-02-27","last_verified_at":"2026-11-03T02:16:24Z","board_verified":false,"closed_at":"2026-11-03T02:16:24Z","days_open":248,"trust":{"level":"ghost","repost_count":0,"flags":["stale","company_stale"],"days_open":247},"description":"Claims Specialist\nAs the Claims Specialist, you will coordinate activities critical to the successful completion of clinical reviews projects. You will support programs by monitoring requests, liaising with clinical partners, managing provider and contractor interactions, tracking deliverables and deadlines, and develop project frameworks to support interdisciplinary and interagency communications. Duties include but are not limited to:\nMonitor appeal/dispute status and communication received on client portals.\nConduct initial eligibility reviews and recommend course of action to internal team and department management.\nTrack and assign cases using commercial off-the-shelf and custom software applications.\nMonitor and measure key performance indicators.\nIdentify barriers and roadblocks in work processes, recommend solutions to solve problems, and execute approved solutions.\nRoutinely present case/project status in huddles and scrums while using an agile, iterative approach to implementation and data presentation.\nSchedule regular team status meetings and record decisions (e.g., assigned tasks and next steps).\nPrepare billing invoices at conclusion of cases, submit to the Finance department, and liaise with accounting to track and trend payments.\nThis is an in office position based in IPRO's headquarter office located in Jericho, NY\nQUALIFICATIONS:\nKnowledge and experience with collaborative project management software, electronic documents, and design.\nAbility to problem solve and work collaboratively with peers, medical, analytical, and administrative support staff.\nExcellent written and verbal skills including phone manner.\nAbility to work independently with little supervision.\nAbility and desire to be flexible, innovative, and creative while multi-tasking.\nAbility to meet deadlines in time sensitive environment.\nEDUCATION & EXPERIENCE:\nBachelors' degree in healthcare, business, management digital studies or related field AND one (1) year experience in medical billing, auditing or claims review, appeals or dispute resolution in healthcare or insurance industries, regulatory, required. \n- OR-\n Associates degree in related field AND two (2) years’ experience in medical billing, auditing or claims review, appeals or dispute resolution in healthcare or insurance industries, regulatory, required. \nThe salary range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The salary range for this position is $66,300.00 to $70,000.00. Actual salary and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.\nThe salary range listed does not include other forms of compensation or benefits.\nIPRO is an Equal Opportunity Employer. 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