Hc And Insurance Operations Associate
Pay or denied various medical claim request received. Handled various types of Institutional(Hospital) & Professional claims. Based on the Authorization and benefits of the member we have approved or denied the Claim for additional information. Stayed up to date on latest plan updates, regulations and policy changes. Processed and adjudicated claims, ensuring resolution for payments and denials. Managed authorization, COB, duplicate, Manual pricing and reclass corrected claims. Consecutively achieving SLA(Service Level Agreement).