Maintains knowledge and understanding of carrier and TPA claims services, programs, capabilities and trends.
July 26, 2022
Review and analyze claims and dental charts submitted by the provider or facility to determine appropriateness of billing and documentation.
January 31, 2023
Manage the claim review process for engaged accounts in accordance with CBC best practices & workflows, and the respective claim discipline adjusters, supervisors, or managers participating in the claim review.
February 05, 2023
Provide relevant special claim handling instructions (SHI) for qualifying accounts, ensure periodic updates for relevancy of SHIs with underwriting, claims, producer, TPA and insured, and provide underwriting with financial guidance on the claim expenses associated with account special services.
March 04, 2023
Understand the competitive marketplace, IT environment, claims operations and data challenges to deliver actionable insights, recommendations and business processes.
March 11, 2023
Contribute to a strong client relationship through interactions with client personnel on investigation-related issues.
March 13, 2023
Developing and executing operational and/or claims audit reviews and projects to completion to include coordinating project and business requirements with technical programming staff.
March 24, 2023
Assisting restructuring professionals with preparation of bankruptcy case filings.
May 15, 2023
Demonstrated ability to independently access a wide range of data and information and develop recommendations in support of business strategies.
May 18, 2023