What are the responsibilities and job description for the Claims Resolution Specialist position at V Group Inc.?
Client : Health Care
Job Title : Claims Resolution Specialist
Duration : 6 Months
Start Date : ASAP
Position Type : Contract
Location : Orange, CA 92868 (Onsite)
Responsibilities : 80% - Claims Support
- Responds and researches issues on provider questions regarding claims payments, denials, resolves claim issues, contractual and / Health agreements, established payment methodologies, division of financial responsibility, applicable regulatory legislation, claims processing guidelines and company policies and procedures.
- Follows up with providers as needed.
- 15% - Administrative Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.
- Ensures accurate and timely documentation regarding all issues, and / or inquiries are entered in Facets.
- Routes escalated calls to the appropriate departments and / or management.
Required :
