Claims Associate

Role & responsibilities

• Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication.
• Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
• Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
• Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
• Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.

Interested candidate share your resume at [email removed] or [phone removed]