Claims - Claims Examiner

4 days ago

PENSACOLA, Florida, United States Wellcove Remote Full-time
Manage and handle all Outbound calls and adjudicate claims.  Duties/Responsibilities: Adjudicating HP/AD claims Handling all Outbound calls Should be able to prioritize work and adjudicate claims as per turnaround time Job involves working independently on researching, reviewing, summarizing, and recommending a course of action on claims  Should have strong English comprehension, mathematics & medical science knowledge to comprehend medical reports To ensure claims are adjudicated as per the client/company guidelines. Provide continual evaluation of processes and procedures.  To respond to and resolves claims received via emails.   Candidate should be able to correctly calculate claim amounts for the customers Complying with company regulations regarding HIPAA, confidentiality, and private health information