Reviews and analyzes data from system-generated reports for in-process claims in order to identify and resolve errors prior to final adjudication.
December 28, 2021
Determines the need for additional information or documentation from participants, employers, providers and other insurance carriers.
April 07, 2022
Manage assigned queues keeping up to date and current on all claims and meeting productivity criteria.
April 20, 2022
Demonstrated ability to effectively communicate with internal and external customers.
June 24, 2022
Maintains current knowledge of BMCHP members' benefits, policies/procedures, provider network development and contract issues, processing system issues, Massachusetts Medicaid regulations, as well as industry standards for claims adjudication.
June 29, 2022