Overview In this role you will adjudicate claims and manage case workflows to ensure timely resolutions. You will support cross-functional questions, provide on-demand reports, and contribute to quality checks and peer reviews. You'll log, track, and review claims with meticulous accuracy while meeting turnaround targets. You work closely with teammates and management to address service issues and maintain high standards. This position offers a focused, detail-driven environment with remote-work flexibility and clear impact on claims outcomes.
Responsibilities- Adjudicate claims and respond to customer and interdepartmental inquiries and escalations
- Provide on-demand reports and periodic status updates
- Assist with peer-to-peer review and internal QC processes
- Communicate via written and verbal correspondence
- Log, track, review, and ensure claims meet turnaround time requirements
- Collaborate with management and team members to address service issues and concerns
- Maintain attention to detail, accuracy, and accountability in all work products
- Operate in a designated quiet area to complete calls while working from home
Key requirements- attention to detail
- organization
- clear communication
- collaboration
