Egg Harbor, United States
11 months ago
Delivers straightforward administrative and/or other basic business services in Claims. Examines and processes paper claims and/or electronic claims. Determines whether to return, pend, deny or pay claims within policies. Determines steps necessary for adjudication. Settles claims with claimants in accordance with policy provisions. Compares claim application and/or provider statement with policy file and other records to evaluate completeness and validity of claim. Interacts with agents and claimants by mail or phone to correct claim form errors or omissions and to investigate questionable entries. Issues tend to be routine in nature. Good knowledge and understanding of Claims and business/operating processes and procedures. Works to clearly defined procedures under close supervision.