Job Description
Join a healthcare organization committed to delivering high-quality service and operational excellence. This role is essential in supporting provider communications and ensuring accurate resolution of claims-related inquiries.
Responsibilities:
* Serve as the primary liaison for written provider inquiries and issue resolution
* Respond to claim-related inquiries from physicians, clinical staff, and provider administrators
* Coordinate with internal departments including Claims, Utilization Management, Provider Relations, and Member Services
* Track, manage, and ensure timely follow-up and closure of all inquiries
* Prepare clear and accurate written responses to providers and maintain detailed records
* Perform data entry into internal systems such as IMAX
* Adjust claims to correct overpayments and underpayments
* Participate in special projects related to claims investigations
* Resolve member billing issues referred from Member Servi...