The Associate of Claims Support receives and responds to provider inquiries on claim issues. The Associate will be responsible for researching information pertaining to health plans, eligibility, and authorizations to determine appropriate resolution.
• Handles various inbound or outbound provider calls which include researching, resolving, and documenting issues.
• Handles RCM authorization and intake changes required for claims and billing processing within a 48 hour turn-around time frame.
• Analyzes data and determines if CareCentrix claims processing guidelines have been followed correctly by researching plan, eligibility, and patient authorization information.
• Tracks claim detail errors and communicates to up-line management for coaching and training purposes.
• HS diploma or equivalent
• 2 years of customer service, claims processing, medical terminology,and medical services experience.
• Knowledge of basic spreadsheet, word processing,data entry, and basic math skills
• Knowledge of Claims Management and URAC standards preferred.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.