Understanding of Medical Claims, Rx Claims, Eligibility/Membership, healthcare insurance benefit and group account setup, Provider data and related processes around them.
April 22, 2023
Required 3+ years of experience in claims processing with a solid understanding of internal company claims functions.
August 29, 2022
Develops knowledge of business information data sources used to gain new insights and understanding of business performance based on data and statistical methods.
December 26, 2022
Participates on conference calls with supervisor/manager/director other departments to provide project status, communicate changes in processes, and issue resolution.
January 08, 2023
Build out our suite of Claims Operations dashboards that will provide executive KPIs and granular operational reporting, including volume, cycle time, material damage, casualty, litigation, and subrogation performance.
January 20, 2023
Support the build out of executive level presentations with actionable insights and recommendations.
February 17, 2023
Provides assistance and support as needed to develop training material on new updates and enhancements.
February 19, 2023
Assist supervisor, manager, and/or director with projects and problem resolution as required.
March 13, 2023
Collaborate with GRS Claims Strategy, Product Teams and Field Operations to develop business cases and specifications for predictive modeling products.
April 20, 2023
Review audit reports for targeted error-prone claims based on historical data and emerging trends.
May 12, 2023