Roles and Responsibilities
- Conduct thorough analysis of medical records and billing documents to determine coverage eligibility.
- Manage insurance claims from receipt to settlement, ensuring timely processing and resolution.
- Negotiate settlements with healthcare providers to minimize out-of-pocket expenses for patients.
- Coordinate with healthcare providers, patients, and insurers to resolve claim-related issues.
Desired Candidate Profile
- 2-5 years of experience in TPA (Third Party Administrator) or similar role.
- Solid knowledge of claims processing, adjudication, and insurance claims procedures.
- Excellent communication skills for effective coordination with stakeholders.