A company is looking for a HC & Insurance Operations Processing Sr Rep.
Key Responsibilities
Process Professional and Hospital claim forms and review policies and benefits
Ensure compliance with HIPAA regulations and maintain quality scores above 98.5 PA and 99.75 FA
Adjudicate claims according to client-defined workflows and respond to claims received via email
Required Qualifications
3 years of healthcare claims processing experience
2 years of experience using Windows applications and navigating multiple computer systems
High school diploma or GED required
Ability to work independently and prioritize tasks effectively
Experience in calculating claims payable amounts using applicable methodologies
