Claims - Claims Examiner
4 days ago
PENSACOLA, Florida, United States
Wellcove
Remote
Full-time
Free with email or Google
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Free with email or Google
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