Reimbursement claims, Pre-authorization, Direct Billing claims

Job Responsibilities Manage and process claims, ensuring proper documentation, verifying eligibility, obtaining necessary pre-authorization, and facilitating billing for reimbursement. Provide accurate and timely medical claims handling services in accordance with company policies, procedures, and standards. Assess, evaluate, and process claims efficiently to support the Claims department's operations. Maintain detailed and accurate records of all claims assessments and decisions. Liaise with internal departments and external medical providers to gather necessary information for claim adjudication. Ensure compliance with regulatory requirements, company guidelines, and SLAs. Contribute to continuous improvement of claims processes and systems. Be flexible to work across different Claims functions as assigned by management.#J-18808-Ljbffr