Job Details

Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. Description Location: This position is full-time (40 hours/week) Monday-Friday in a typical office environment. This role is located on-site at 1000 Executive Center Drive Greenville, SC 29616 What Youll Do:Respond to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Accurately documents inquiries. Identify incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines. Examine and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enter cl...Customer Service, Claims, Advocate, Processing, Service, Retail, Healthcare