Medical claims Officer - MCC

Description:

The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process OP claims according to operations set standards

Key responsibilities/What you do:

• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.
• Evaluates OP claims with regards to eligibility.
• Apply nextcare cost containment protocols for OP claims at the retrospective review level
• Attends calls and e-mails from insurance companies, clients, and providers.
• Makes suggestions to improve service.
• Increase efficiency, minimize errors, and reduce administration time through AI-powered automation.

AI READINESS Work effectively in an environment shaped by artificialintelligence (AI), machine learning, data analytics and cloud-based tools, us...