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Nevada 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 Collaborate with various business units to resolve claims issues and ensure prompt and accurate claims adjudication 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
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
Collaborate with various business units to resolve claims issues and ensure prompt and accurate claims adjudication
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
