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Perform detailed pre-call analysis to identify root causes of unpaid or underpaid claims
Contact insurance payers via calls, IVR, or web portals for claim status and resolution
Handle claim denials and aged accounts by identifying issues and suggesting corrective actions
Accurately document claim activities in client systems for compliance and audit purposes
Analyze Explanation of Benefits (EOBs), medical records, and payer communications
Prepare and submit appeals for denied or underpaid claims within defined timelines
Track high-value and aged claims until closure
Collaborate with internal teams to improve process efficiency and data accuracy
Ensure compliance with HIPAA, ERISA, and payer-specific guidelines
Support audits and mentor junior team members for performance improvement
Job ID: 145002901