Senior Claims Associate

7 days ago

Tampa, Florida, United States Avalon Administrative Services, LLC dba Avalon Healthcare Solutions Full time
About Avalon Healthcare Solutions

Avalon Healthcare Solutions is a leading provider of Lab Insights solutions, revolutionizing the way healthcare insurers approach care and reduce costs. Our innovative platform captures, digitizes, and analyzes lab results in real-time, empowering informed decision-making and driving better clinical outcomes.

Job Summary

We are seeking a highly skilled Business Claims Associate to join our Claims Operations Department. As a key member of our team, you will play a critical role in ensuring the efficient processing of claims and resolving provider issues. Your expertise will help us maintain high-quality service standards and drive business growth.

Key Responsibilities
  • Evaluate disputed claims in the Reconsideration process and collaborate with Senior staff to determine scope
  • Perform outbound calls to Health Plans to investigate aging reconsideration submissions and claims payment details
  • Visit the office weekly to open mail, scan documents, and distribute paper checks to finance
  • Store and maintain multiple electronic documents
Qualifications
  • Experience with Provider credentialing is preferred but not required
  • Intermediate knowledge of Microsoft Office Suite products
  • Experience with using eFax and performing outbound phone calls to clients

Avalon Healthcare Solutions is an equal opportunity employer committed to diversity and inclusion. We welcome applications from talented individuals who share our passion for delivering exceptional service and driving business success.

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