Medical Claims Negotiator II
6 days ago
Job Description: As a Medical Claims Auditor / Advocate II, you'll review patient medical bills, correspondence, and Explanation of Benefits (EOBs) for errors. You'll liaise with insurance carriers and providers to address identified issues, communicate with providers and carriers via phone and email, and use management reports and critical thinking skills to identify problems and inconsistencies.
Key Responsibilities:
- Review patient medical bills, correspondence, and EOBs for errors.
- Liaise with insurance carriers and providers to address identified issues.
- Communicate with providers and carriers via phone and email.
- Use management reports and critical thinking skills to identify problems and inconsistencies.
- Utilize expertise and take initiative to resolve claims/billing issues.
- Apply appropriate processes and procedures for medical claims.
- Review and apply member benefit plans and provider contracts.
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Claims Reviewer and Medical Bill Negotiator
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Healthcare Claims Negotiator
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