Claims Resolution Specialist

Job Summary:The primary role of the Claims Resolution Specialist is to facilitate a seamless claims process by scrutinizing claim documents, collaborating with internal stakeholders, and ensuring timely receipt of all required documentation.Key Responsibilities:Review and verify claim documents against established proceduresIdentify discrepancies between...

Intelligent Claims Resolution SpecialistWe are seeking a skilled professional to orchestrate Large Language Models (LLMs) and Small Language Models (SLMs) that optimize revenue cycle processes, minimize Accounts Receivable (AR) dollars, and improve claim resolution efficiency.About the Role:The ideal candidate will work closely with healthcare experts and...

Claims Handling SpecialistThe Claims Handling Specialist is responsible for managing all aspects of claims, ensuring fair settlement and adherence to legal requirements.Key responsibilities include receiving and answering emails and telephone calls related to claims, advising policyholders on claim procedures, and ensuring timely resolution of...

Job OverviewWe are seeking a highly skilled and detail-oriented Financial Claims Specialist to join our team. This role is responsible for managing and resolving insurance and patient payment collections to ensure timely revenue realization.Key Responsibilities:Proactively follow up with insurance companies (Medicare, Medicaid, Commercial) via phone, portal,...

Job DescriptionWe seek an expert to manage denied claims and identify revenue gain opportunities. The successful candidate will review open AR claims, identify trends through data analysis, and coordinate with stakeholders to address issues.Key Responsibilities:Conduct thorough reviews of denied claims and account-level dataAnalyze data to identify process...

Job Description:As a Trade Claims Specialist, you will be responsible for end-to-end trade claim calculation, verification and finalization. You will work closely with the team to ensure accurate and timely processing of trade claims.Your key responsibilities will include:Trade Claim calculation and verificationNMC claim verifications and DM difference...

The ideal candidate for this role will have 3-5 years of experience in a similar position, with a strong understanding of claim processes and procedures. This experience should be focused on reviewing distributor claim documents thoroughly, ensuring completeness according to a set checklist.Key Responsibilities:Claim Scrutiny: Detail-oriented review of...

Claims Associate Role OverviewThe Claims Associate will be responsible for processing claims in accordance with company policies and procedures.Key Responsibilities:Evaluate and process claims in a timely manner.Maintain production and quality standards based on quality control expectations.Adapt to cross-training and multiple tasking requirements.Process...

Are you looking for a challenging role where you can utilize your problem-solving skills and conflict resolution abilities? As an Employee Relations Specialist, you will be responsible for investigating workplace situations, grievances, conflicts, and employee issues. Your objective will be to ensure timely closure of investigations and maintain accurate...

Job Title: Critical Incident Resolution SpecialistAs a Critical Incident Resolution Specialist, you will play a pivotal role in resolving complex technical issues across multiple business systems. Your primary objective will be to ensure operational stability and provide exceptional support to our customers.Key Responsibilities:Independently investigate and...