Claim Benefit Specialist- Franklin, TN.
Core
Reviews and processes medical benefits claims submitted by healthcare providers, verifying policy coverage and ensuring accurate reimbursement.
Role type
Claims processing specialist
Builds
Medical claims processing workflow
Domain
Healthcare administration
Required skills
claim documentation review, policy coverage verification, claim validity assessment, medical coding knowledge, billing practices, system data entry, regulatory compliance, stakeholder communication
Preferred skills
medical claim processing experience, production environment experience, multi-tasking, organizational skills
Responsibilities
Process benefits claims from healthcare providers, determine eligibility and coverage, assess claims for accuracy and compliance, document claim information in company systems, conduct reviews and investigations of claims, communicate with providers and patients to resolve discrepancies, analyze claims data to identify trends and inform process improvements