Manage all aspects of multi-line claims generated by assigned group of agents including claim examination, investigation, determination of coverage, liability, compensability, subrogation, etc., adjustments, litigation and settlements within limit of assigned authority levels. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.
Receive claim assignments from assigned agents, verify applicability of coverage.
The Certified Coding Specialist is primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client. The ideal candidate will have some of these licenses or designations. Certified Coding Specialist, CCS, Registered Health Information Analyst, RHIA, Registered Health Information Technician, RHIT, hospital claims, CPT, HCPCS, ICD-9, ICD-10, DRG.
Essential Duties and Responsibilities of the ...
JOB ID: MI24964
Job Title: Insurance Claims Adjuster
Company: Job Chit Chat
Industry/Environment: Insurance (professional, motivated & results driven)
Investigates, analyzes, and determines the extent of liability concerning loss or damages on high complexity claims to secure an accurate and fair settlement
Interpret complex policy language
Experience interpreting complex policy language
Exceeds expectations ...
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