Claims Research amp Resolution Professional 2

Profile

Description

The Claims Research & Resolution Professional 2 manages claims operations that involve customer contact, investigation, and settlement of claims for and against the organization. Approves all claim settlements both for and against the organization. The Claims Research & Resolution Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Claims Research & Resolution Professional 2 works with insurance companies, providers, members, and collection services in the settlement of claims. Comprised of a group of calls/claims/provider associates researching the resolution to a pending call. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications


Bachelor's degree
Less than 5 years of technical experience
Must be proficient in Excel
Must be able to work independently with minimal supervision
Claims experience
Detail oriented
Must be passionate about contributing to an organization focused on continuously improving consumer experiences


Preferred Qualifications


Experience using Oracle


#Author

Scheduled Weekly Hours

40

Company info

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