Description
The Claims Operations Associate is liable for coping with claims and approvals techniques, and the scope of labor consists of vetting medical insurance claims and approval from provider providers, reconciling bills and negotiating and importing declare price lists.
Job Description
- Examine and approve or reject healthcare providers` claims to satisfy set targets.
- Investigate claims for fraud, waste and abuse.
- Promptly solve escalated approval requests for care.
- Negotiate price lists and replace the providers` dashboard and execute different factors of tariff control.
- Collaborate with the generation crew to enhance the techniques claims, tariff and approvals control system
- Collaborate with patron achievement and issuer members of the family groups to make sure patron pleasure goals
Requirements
- Minimum of a primary diploma in medicine, nursing or pharmacy and of of entirety of internship or housemanship.
- Previous revel in in a declare examiner position is a chief advantage.
- Excellent numeracy, analytical and problem-fixing skills.
- A high-degree of responsiveness is crucial and openess to operating shifts which includes occasional weekends.
- Strong scientific and medical information and revel in.
- Excellent interpersonal and communique skills.
Benefits
- Work alongside & learn from best-in-class talent
- Join a market leader within the health Insurance space
- Work remotely
- Fantastic work culture
- Great work-life balance
Pour postuler, veuillez cliquer sur ce lien : apply.workable.com.
