Walk-in || Claims Representative

Primary Responsibilities:

• Analyze medical claims to identify overpayments and recovery opportunities
• Validate claims accuracy using CPT-4, J-codes, and ICD diagnosis/procedure coding
• Initiate and follow up on recovery processes to secure savings
• Maintain accurate and up-to-date documentation of all recovery activities
• Communicate with internal teams and external stakeholders to resolve discrepancies
• Ensure compliance with quality standards and productivity targets
• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so