Claims Liaison

A company is looking for a Claims Liaison I to serve as a liaison between the plan, claims, providers, and various departments to resolve claims issues. Key Responsibilities Audit check runs and send claims to the claims department for corrections Collaborate with various business units to resolve claims issues and ensure accurate claims adjudication Research and analyze claims processing issues and identify trends for potential improvements Required Qualifications 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 CPC certification preferred Knowledge of provider contracts and reimbursement interpretation preferred

Feb 12, 2025 - 13:33

A company is looking for a Claims Liaison I to serve as a liaison between the plan, claims, providers, and various departments to resolve claims issues. Key Responsibilities Audit check runs and send claims to the claims department for corrections Collaborate with various business units to resolve claims issues and ensure accurate claims adjudication Research and analyze claims processing issues and identify trends for potential improvements Required Qualifications 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 CPC certification preferred Knowledge of provider contracts and reimbursement interpretation preferred