The Claims Support Assistant is responsible for reviewing incoming documentation and entering data into proprietary systems to support insurance claims processes. They will also handle inquiries, manage sensitive information, and coordinate with internal and external partners to ensure tasks are completed on time.
The Claims Processor is responsible for reviewing and processing insurance claims by verifying coverage, evaluating validity, and determining payout amounts. They also provide support to litigation and legal departments while ensuring compliance with HIPAA regulations.
The Bill Repricer processes and reprices auto medical claims while maintaining regulatory SLAs and daily quotas. They are responsible for manually keying medical bills and associating documents with the correct claim files in the system.
The incumbent reviews medical bills and documentation to determine the relationship of services to covered injuries and assesses the appropriateness of medical coding. They also provide customer service to adjusters and providers while making reimbursement recommendations for workers' compensation claims.
The incumbent reviews medical bills and documentation to determine the relationship of services to covered injuries and assesses the appropriateness of medical coding. They also provide customer service to adjusters and providers while making reimbursement recommendations for workers' compensation claims.
The Field Nurse Case Manager coordinates care for individuals injured in automobile and work-related accidents by liaising with healthcare providers and insurance carriers. This role involves traveling to patient homes and physician appointments to manage medical claims effectively.
