HC & Insurance Operations Senior Rep.

Responsibilities-

- Review & Analyze Healthcare payer claims including HCFA & UB forms.

-Validate Member, Provider and other Claims information. -Review the accurate payment based on defined Policy and Procedure.

-Review Coordination of Claim Benefits based on the Policy & Procedure.

-Maintain productivity goals, quality standards within required timeframes.

-Scrutinizing Medical Claim Documents and settlements. -Organizing and completing tasks per assigned priorities.

-Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team

-Resolving complex situations following pre-established guidelines

Requirements for this role include:

-University degree or equivalent that required formal studies of the English language and basic Math

- <1 Year of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.