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Claims - Claims Examiner
Wellcove CHCS Services
Pensacola, FL
Category
Insurance
Apply for Job
Remote
Job Description
Wellcove is seeking a Claims - Claims Examiner to manage and handle all Outbound calls and adjudicate claims. The ideal candidate will have experience in handling US HIP claims, knowledge of medical terminology, human anatomy, and basic math knowledge.
Requirements
Adjudicating HP/AD claims
Handling all Outbound calls
Prioritizing work and adjudicating claims as per turnaround time
Researching, reviewing, summarizing, and recommending a course of action on claims where an appeal or a grievance has been filed for a denied / under payment
Responding to and resolving claims received via emails
Calculating claim amounts for customers
Complying with company regulations regarding HIPAA, confidentiality, and private health information
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