Claims Processing Manager
4 days ago
About the Role:
We are seeking a highly skilled and experienced Sr. Health Claims Analyst to join our team. The successful candidate will be responsible for reviewing and assessing claims, ensuring accurate benefit payouts, and maintaining compliance with policy details, laws, and regulations.
Key Responsibilities:
- Conduct thorough analysis of claims and determine eligibility for benefits.
- Make informed adjudication decisions and provide recommendations within prescribed approval limits and turnaround times.
- Collaborate with the Third-Party Administrator (TPA) to review and approve recommendations and decisions.
- Maintain accurate and up-to-date records of claims, communications, and resolutions in the claims management system.
What We Offer:
- A competitive salary and comprehensive benefits package.
- A collaborative and dynamic work environment.
- Opportunities for professional growth and development.
Our Values:
Customer obsession: We put our customers at the forefront of everything we do.
Innovative thinking: We encourage creativity and out-of-the-box solutions.
Teamwork: We believe in collaboration and working together towards a common goal.
Integrity: We operate with honesty and transparency in all aspects of our business.
Social responsibility: We prioritize diversity, equity, and inclusion, and strive to make a positive impact on society.
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