This Fortune 500 client is a nation-wide leader in the healthcare services field and they pride themselves on their ability to provide a wide range of government sponsored healthcare programs; including a variety of insurance solutions. Currently, they are seeking a Healthcare Claims Representativeto Serve as a liaison between the plan, claims, providers and various departments to effectively identify and resolve claims issues
Location: Maitland, FL
Similar positions: Claims Liason, Healthcare Clerk, Billing Clerk
Review Claims and submit for corrections
Rearch Claims to determine eligibility and Identify authorization issues and trends
Identify system changes and work with manager in order to implement
Oversee plan provider resolution projects
Document eligibility issues and assist to create process changes
Produce provider claims report and analyze trends
High school diploma or equivalent.
3+ years of claims processing, provider billing, or provider relations experience, preferably in a managed care environment.
Proficient in Excel and Microsoft Office Suite
CPC certification required
Knowledge of provider contracts/reimbursement interpretation preferred.
Applicants must be currently authorized to work in the United States on full-time basis