Claims Associate
CurrentInvestigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.Obtain vehicle information from the DMV.Follow HIPAA policy on each and every call.Abided by the laws and regulations associate under HIPAA and patient confidentiality.Receive recognition for creating a workflow and database for all incoming subpoenas.Assist in training new CSA s on job responsibilities, which increase… Show more Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.Obtain vehicle information from the DMV.Follow HIPAA policy on each and every call.Abided by the laws and regulations associate under HIPAA and patient confidentiality.Receive recognition for creating a workflow and database for all incoming subpoenas.Assist in training new CSA s on job responsibilities, which increase office productivity.Ensure compliance with company regulations and Medicaid requirements.Coordinate Medicare, Medicaid, and secondary insurance coverage.Gather and compile evidence to support contest claims in litigation.Review automobile titles, completing transfers and owner retention DMV documents with customersConduct detail bill reviews to implement sound litigation management and expense control.Identify claims for potential fraud and abuse and process expedited appeals and organizational determinationsDevise creative and cost-effective incentive and morale-boosting programs that increase CSA satisfaction and productivity.Execute effective and efficient claim dispute resolutions in regard to provider and facility appeals. Show less
