Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic Verbal and written communication skills -Intermediate Attention to detail ensuring accuracy - Basic Ability to work in a high volume, fast paced environment managing multiple priorities - Basic Analytical Thinking - Basic Judgment/ Decision Making - Basic.
February 23, 2020
Assist in the department's effort to continuously improve service by identifying and recommending changes or additions to current workflow, practices, processes, procedures, systems, and training.
March 05, 2020
Handle calls from the Nationwide Toll-Free Service which may originate from any area within the network or from another network-this comprises of about 65% of the position.
April 05, 2020
Performs timely and thorough investigations in an effort to comply with all jurisdictional requirements and/or entitlements.
April 13, 2020
Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
May 08, 2020
Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practice requirements and company policy and procedures.
May 17, 2020
Review and research incoming healthcare claims from members and providers(doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing .
May 18, 2020