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claims processing or medical/vision Specialist Location: US-OH-Mason Jobcode: 046fb07fc490ac700e793a1d09ddafe9-122020 Email Job
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claims processing or medical/vision Specialist needs 2 years practical work experience in claims, service or health services environment.
claims processing or medical/vision Specialist requires:
- knowledge of claims processing or medical/vision benefits and product experience
- Quality assurance experience
- 2 years practical work experience in claims, service or health services environment.
- One year experience in healthcare related appeals/grievances,
- High level of professionalism and ability to deal with sensitive information
- Strong oral and written communication skills
- Ability to work well under pressure and multi-task
- High sense of urgency and ability to manage to strict deadlines
- Demonstrated resourcefulness in resolving problems
- Demonstrated ability to learn new technology systems and query reporting
claims processing or medical/vision Specialist duties:
- Follow up with providers to obtain missing information for clean claim to ensure approval/denial from Medical Director.
- Compose letter to inform provider of approval/denial of medically necessary claim. Log, track and report on all medically necessary claims.
- Meets established productivity and quality standards.
Global Channel Management, Inc.
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