Claims Resolution Expert
hace 2 semanas
**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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