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Claims Investigation Professional
1 week ago
- Provide claims expertise support by reviewing, researching, investigating, negotiating, and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.
- Analyze, identify trends, and provide reports as necessary.
- Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance.
- Manage subrogation files.
- Comply with employment contract terms, company policies, and procedures.