Claims Research Specialist
Our Claims Research Specialist is the face of the claims department to providers and customers in contacting CCS for questions regarding claims authorization, payment and related workflows. They document calls issues, insure follow-up and proper resolution of all complaints and problems.
- Associates degree or similar medical claims experience
- Excellent written and verbal communication skills
- Three (3) or more years of medical claims investigation experience.
- Prior experience on the phones researching and resolving claims issues.
- Strongly analytical, research and problme solving skills
- None required
- Receive calls from providers and customers dealing with medical claims issues.
- Document each call in salesforce review/track all correspondence recieved.
- Resolve all claims issues by performing all necessart research and comunicate solutions in response to customer
- Triage issues and determine for cross-functional department involvement in resolving billing claims issues.
- Research and answer questions from providers, customers or sites regarding claims payment, eligibly and authorizations for services.
- The above responsibilities are a highlight of responsibilities and not a full list. Other responsibilities may be performed as assigned.