Certificates : Evidencia de estudios (Mandatory)
Division/Department : Claims
Skills : Patience, Communication, Interpersonal skills, Teamwork, Flexibility, Ability to multi-task, Judgement, Initiative, Customer focus, Work ethic, Stress management, Attention to detail
Experience : 2 Years
Reports to :
Shift type : FullTime | Salary type : Nonexempt
Job Description : Analyzes claims and/or adjustments in 1500, UB04 format and member reimbursements by applying payment rules for payment adjudication and denial and/or requests for additional information, such as original claims, adjustments, COB, and grievances, from PR and non-participants including US claims applicable up to a maximum adjudication limit established in the current policy and procedure.