Remote Claims Benefits Rep (Atlanta, GA)

Remote Claims Benefits Rep

Remote Claims Rep needs 2 years practical work experience in claims service or health services environmentRemote Claims Rep requires 1 year experience in healthcare related appeals grievances preferred High School Diploma required. Preferred knowledge of claims processing or medical vision benefits and product experience High level of professionalism and ability to deal with sensitive information Strong oral and written communication skills Ability to work well under pressure and multi-task High sense of urgency and ability to manage to strict deadlines Demonstrated resourcefulness in resolving problems Demonstrated ability to learn new technology systems and query reporting Ability to work independently Quality Assurance Remote Claims Rep needs Resolution of member and provider complaints and appeals related to quality of care access to care and benefit determination. Compose letter to inform provider of approval denial of medically necessary claim Log track and report on all medically necessary claims. Meets established productivity and quality standards. Follow up with providers to obtain missing information for clean claim to ensure approval denial Conducts research and secures required information including requesting member records claims analysis transaction event documentation. Prioritizes and analyzes member and provider issues and seeks