Claims Resolution Expert

hace 2 semanas


San Francisco, Heredia, Costa Rica Auxis A tiempo completo

**Job Requirements:**

The Claims Resolution Expert is responsible for performing end-to-end tasks for technical appeals, ensuring timely resolution and customer satisfaction.

**Key Responsibilities:

  • Triage incoming inventory for the Appeals team, validating appeal criteria
  • Compose technical denial arguments for reconsideration, including written and telephonic communication
  • Identify contract protection that can be leveraged to overturn denials
  • Overcome objections that prevent payment of the claim through concise and effective appeal argument

**Required Skills and Qualifications:

  • Communication - Clearly communicates verbally and in writing, utilizing proper punctuation, correct spelling, and transcription accuracy
  • Customer Orientation - Establishes and maintains long-term customer relationships by consistently meeting and exceeding expectations
  • Interpersonal Skills - Works effectively with other employees, patients, and external parties
  • Policies & Procedures - Demonstrates knowledge and understanding of organizational policies, procedures, and systems
  • Technical Skills - Represents facilities in legal settings, performs basic mathematical calculations, balances figures, punctuates properly, spells correctly, and transcribes accurately

**Benefits:*

  • Health benefits including medical, vision, and dental
  • Transportation subsidy
  • Asociacion Solidarista
  • Training and development programs
  • Employee recognition program
  • Paid time off and family paid leave
  • Paid day off for your birthday


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