Job Details

Your role in our mission Supervises claims program administration to ensure proper claims practices and procedures. Supervises billing, claims and associated administrative activities to ensure compliance with laws, regulations, policies, agreements and contractual arrangements. Assists in implementing procedures to adjust claims when original demographic, sponsor or charge information is in error; monitors and controls resubmission of denials, rejections and appeals. Intercedes with third parties in unusual situations involving payment or adjustment of charges on accounts; consults with departments concerning services which affect collection of charges. Assists examiners in investigating claims and assists and/or performs settlement negotiations. Supervises claim settlement processing. Assumes supervisory responsibility for electronic and paper claims submissions; oversees analysis, correction and resubmission of registration and eligibility of edits and errors. Recommends and/or init...Claims, Supervisor, Healthcare, Experience