Claim Examiner // Orlando FL 32822

Claim Examiner // Orlando FL 32822

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at http://www.mindlance.com.

Business Claim Examiner

Visa GC/Citizen

Location 6272 Lee Vista Blvd, Orlando FL 32822

Division Pharmaceutical

Pay Negotiable

Contract 6 Month

Timings Mon - Fri between 8.00AM – 5.00PM

Qualifications

POSITION OVERVIEW

·Verify member submitted claims forms, member's eligibility & pharmacy information is complete & accurate, updating system information as needed.

·A high data entry proficiency is expected in order to provide accurate & timely processing of claims submitted by member, pharmacy or agencies.

·Moderate knowledge of drugs & drug terms used daily.

·Process claims according to client specific guidelines while identifying claims requiring exception.

·Navigate daily through several platforms to research & finalize claim submissions.

·Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues.

·Adhere to strict HIPPA regulations especially when communicating to others outside of ESI.

·Prioritize & coordinate influx of daily workload for claims processing, returned mail & outgoing correspondence & e-mails to assure required turnaround time is met.

·Assess accuracy of system adjudication & alert management of potential problems affecting the integrity of claim processing.

·Analyze claims for potential fraud by member or pharmacy.

·May be required to work on special projects for claims team.

If you are available and interested then please reply me with your “Chronological Resume” and call me on (678)-405-3590.

Additional Information

Thanks & Regards,

Ranadheer Murari |Team Recruitment |Mindlance, Inc. | W:678 405 3590

ranadheerm@mindlance .com