Job Description
OBJECTIVE:
We are looking for a skilled and detail-focused Medical Claims Reviewer to perform comprehensive reviews of medical, surgical, and Medical health claims for inpatient and outpatient services. This role involves using your clinical expertise, coding proficiency, and claims processing knowledge to assess and approve claims accurately and efficiently. You will ensure claims are aligned with program benefits and assist various stakeholders by providing coding-related insights and resolving inquiries related to claims processes.
ESSENTIAL DUTIES AND RESPPONSIBILITIES:
COMPETENCIES:
EDUCATION AND EXPERIENCE REQUIRED:
WORKING CONDITIONS/PHYSICAL DEMANDS:
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