02/04/2025
Job Responsibilities and Requirements The Claims Examiner will act as a liaison between client, employee and healthcare provider. In this position, you are responsible for applying appropriate claims management by providing reliable and responsive service to claimants and clients. Description of responsibilities: Investigates claim issues providing resolution within departmental and regulatory guidelines. Interprets and administers contract provisions: eligibility and duration Accurately codes all system fields with correct financial, diagnosis and duration information. Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work. Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations. Actively contributes to customer service, quality and performance objectives. Proactively engages in departmental training to remain current with all claim management practices. Responsible for...
Reliance Matrix
Hawthorne, NY, USA