What are the responsibilities and job description for the Claims Service Correspondent position at MetroPlusHealth?
Position Overview
The Claims Service Correspondent is responsible for accurate and timely response to written claim inquiries received from providers. This individual provides support regarding the adjudication and adjustment of claims for multiple lines of business. They will work closely with Provider Contracting, Medical Management, Enrollment and Membership department, and Claims Processing unit.
Job Description
- Act as a key liaison and service representative for all written provider inquiries and problem resolution.
- Respond to all claim inquiries from provider sites including physicians, clinical staff, and site administrators.
- Coordinate and track appropriate problem resolution activities with plan personnel in other departments (i.e., Claims, Utilization Management, etc.)
- Manage and ensure appropriate follow-up and closure for all inquiries.
- Respond to providers’ inquiries in writing and maintain accurate tracking.
- Data entry into the IMAX system.
- Perform claim adjustments to correct erroneous payments (overpayments / underpayments).
- Participate in special projects involving Claim Status Investigations.
- Resolve Member Bills referred from Member Services.
Minimum Qualifications
Professional Competencies
Salary : $49,000 - $55,482
