Job Description

Description

The role involves providing administrative support (primarily in the form of data entry). Duties in the job include transferring data using Microsoft excel and sorting it with intermediate functions. Candidates will require a degree of comfortability when it comes to math due to nature of the role and what they will be dealing with. Other duties include using spreadsheets to track customer information, organizing data, administrative support, data review for errors, and to provide data entry support as needed. Other duties as needed.

  • Review and adjudicate all types of claims designated as “production claims”, meeting production and quality goals.
  • Review, investigate, and apply all necessary criteria to determine validity of claim.
  • Apply benefit plan rules and processing guidelines to pay, pend, or deny claims.
  • Review and determine eligibility and coverage for specific group/plan.
  • Research claim problems and take necess...

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