Florida Licensed 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 effectively identify and resolve claims issues. Key Responsibilities Audit check runs and send claims to the claims department for corrections Document, track, and resolve all plan providers' claims projects Analyze trends in claims processing issues and assist in identifying and quantifying issues 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/reimbursement interpretation preferred

Mar 17, 2025 - 04:15

A company is looking for a Claims Liaison I to serve as a liaison between the plan, claims, providers, and various departments to effectively identify and resolve claims issues. Key Responsibilities Audit check runs and send claims to the claims department for corrections Document, track, and resolve all plan providers' claims projects Analyze trends in claims processing issues and assist in identifying and quantifying issues 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/reimbursement interpretation preferred