- Processed claims and prior approvals accurately and in a timely manner.
- Responsible for processing the measurement of ads.
- Performance of mathematical calculations, comparing advertising content to client’s program guidelines to ensure compliance.
- Preparation of input sheets and/or entering audit results into client’s processing database or web application.
- Assist with customer service via telephone, email, and/or fax, special projects and the preparation of reports.
- Coordinate with adjusters and reviewers to move claims forward
- Upload completed files to server and close claims upon completion
- Run end of day reports for claims manager
- Analyze information gathered by investigation, and report findings and recommendations. on all claims related business.
- Analyze and processed claims for medical expenses within the fixed turn around time.
- Review claim edit trends and provider billing issues
- Used several applications and company based software to price medical claims based on the agreement between the company and the medical provider.
- Explain claims decisions, estimates, and all other records related to claims that involve insurance coverage.
- Prepares special loss reports as needed.