Claims Examiner
Current- Process In-Network, Out-of-Network, SubPay and BlueCare claim types based on policy coverage for providers out of state with top-performing accuracy.- Focus on reviewing all aspects of the claim, preliminary investigation and effective communication through Facets, Claims Admin and Blue2 during the claims process. - Collaborate with PNC to load billing, performing and referring providers to sustain quality networks and benefits for members. - Diligently review policies and procedures to ensure that no errors are made and benefits are applied correctly.