Claims Resolution Specialist

Job DescriptionWe are seeking a Claims Resolution Specialist to join our team. This role involves reviewing, researching and resolving claims for health plans, commercial customers and government entities.As a Claims Resolution Specialist, you will be responsible for analyzing and identifying trends and providing reports as necessary. You will also ensure...

The Claim Resolution Specialist plays a versatile role in the claims workflow, tasked with submitting appeals to overturn denials and trigger payments or determining whether further action, such as additional appeals or account closure, is required. Specialists in this role may prioritize tasks based on claim complexity and workload, ensuring optimal...

Job SummaryA Claims Resolution Specialist is responsible for reviewing and evaluating customer claims, ensuring their accuracy, eligibility, and compliance with company policies. This involves investigating claims, determining validity, and customer settlement amounts while maintaining detailed records and communicating with team leads for approval.Key...

Remote Claims Resolution SpecialistThe Remote Claims Resolution Specialist will be responsible for investigating and resolving customer claims related to branded and imprinted merchandise. These claims may include imprinting errors, delivery delays, pricing discrepancies, incorrect products, or issues affecting overall product quality and integrity.Key...

Job Overview:This role entails reviewing and resolving provider disputes in accordance with regulatory requirements and internal policies.Key Responsibilities:Investigate and resolve provider disputes related to denied, underpaid, or incorrectly processed claims.Analyze claims history, adjudication data, and notes using EZCap.Interpret health plan policies,...

The role of a claims handler involves the review and evaluation of claims assigned to this position. It is essential to attend to inquiries from insured clients and walk-in customers at the assigned location. Additionally, the claim handler must approve LOA within the assigned authority limit if applicable.Maintaining knowledge of claim documentation is also...

Delegate CX is seeking a highly skilled and detail-oriented Claims Representative to join its team.Job Description:The role of the Claims Representative will be to investigate and resolve customer claims related to branded and imprinted merchandise.Responsibilities:Investigate incoming customer claims related to promotional product orders.Collaborate with...

Medical Billing Specialist OpportunityWe are seeking a detail-oriented Medical Billing Specialist to support the revenue cycle operations of our healthcare client.This role is primarily focused on reducing claim denials and recovering aging or stale claims.You will be working directly in our clients billing system, managing claim queues, and communicating...

Claims Manager RoleA dynamic opportunity to manage and resolve claims efficiently.This is a challenging role requiring strong analytical and problem-solving skills, with the ability to build effective relationships with internal and external stakeholders.Manage existing and assigned claims from loss notification up to settlement in accordance with industry...

Healthcare Claims SpecialistIn this challenging role, you will play a pivotal part in enhancing healthcare outcomes by connecting individuals with essential resources and services.The ideal candidate will possess a college degree and at least one year of experience in claims or collections, along with strong analytical and problem-solving skills.Main...