About the role
OverviewWork alongside an engaged onsite team focused on claims resolution, compliance, and customer service excellence.Ā š» Work Style: Onsiteš Location Requirement: Gainesville, FLš FTE: Full-Time (1.0 FTE)Ā Manages and evaluates insurance claims to ensure accurate coverage and timely processing.
Details
- Schedule
- FULL_TIME
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- Work alongside an engaged onsite team focused on claims resolution, compliance, and customer service excellence. š» Work Style: Onsiteš Location Requirement: Gainesville, FLš FTE: Full-Time (1.0 FTE) Manages and evaluates insurance claims to ensure accurate coverage and timely processing. Investigates claims, negotiates settlements, and responds to inquiries from claimants and related parties. Assists clients in submitting claims correctly and coordinates with internal teams to facilitate efficient claim resolution. Maintains detailed records and verifies claim compliance are key to supporting audit and regulatory requirements. ResponsibilitiesKey Responsibilities
- Manages and evaluates insurance claims for accuracy and timely processing.
- Investigates claims and negotiates settlements.
- Responds to inquiries from claimants and related parties.
- Assists clients in submitting claims correctly.
- Coordinates with internal teams to facilitate claim resolution.
- Maintains detailed records and verifies claim compliance. QualificationsEducationHigh School Diploma/EquivalentRequired Skills & Qualifications2+ years of experience in insurance claims processing and supportKnowledge of insurance policies and claim adjudicationExperience investigating and resolving claim issuesStrong communication and customer service skillsAbility to maintain detailed records and ensure compliancePreferred ExperienceExperience verifying patient insurance eligibility and working with commercial and government payers, including BCBS, Medicare, Medicaid, and third-party insurance carriers preferredEpic experience required, with familiarity using computerized insurance billing systems and Microsoft Office programs preferredStrong communication, organizational, and problem-solving skills with the ability to work independently in a fast-paced environmentAbove-average math aptitude with strong attention to detail and accuracyAbility to interact professionally with patients, payers, and internal teams while exercising sound judgment in account resolutionKnowledge of medical terminology preferredDemonstrated ability to consistently achieve performance expectations while managing multiple priorities under pressure
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