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Medical Claims Investigator

1 month ago

Louisville, Kentucky, United States CenterWell Home Health Full time

About the Role:

We are seeking a skilled Medical Claims Investigator to join our team at CenterWell Home Health. As a Medical Claims Investigator, you will be responsible for conducting comprehensive analytic reviews of clinical documentation to determine if an appeal is warranted.

Key Responsibilities:

  • Manage client medical denials by conducting thorough reviews of clinical documentation.
  • Apply advanced administrative and customer support skills to resolve complex issues.
  • Work independently with minimal supervision, exercising discretion and judgment in prioritizing requests and interpreting procedures.
  • Collaborate with cross-functional teams to ensure seamless delivery of services.

Requirements:

  • 2+ years of experience working with customers in a fast-paced, deadline-oriented environment.
  • Strong analytical and decision-making skills, with the ability to work independently and prioritize tasks effectively.
  • Excellent communication and interpersonal skills, with the ability to build strong relationships with clients and colleagues.
  • Proficiency in multiple software systems and a willingness to learn new technologies.

What We Offer:

  • A competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • A dynamic and supportive work environment.

How to Apply:

If you are a motivated and detail-oriented individual with a passion for healthcare, please submit your application, including your resume and a cover letter, to [insert contact information].