Assist internal business partners with deep dive analysis of provider relations concerns; present opportunities to internal business partners and management on trends found in provider billing, UHC systems and processor limitations; analysis of current over payments for potential system or processing enhancements; advanced knowledge of Excel, PowerPoint; Project Management.

Review submitted projects of 20 claims or more in an end-to-end process, from initial Provider contact, identification of Claim Payment issue, facilitation of resolution of Claim Payment issues and communication of outcome to Provider. Accountable for accurate documentation and routing of issues to… Show more Review submitted projects of 20 claims or more in an end-to-end process, from initial Provider contact, identification of Claim Payment issue, facilitation of resolution of Claim Payment issues and communication of outcome to Provider. Accountable for accurate documentation and routing of issues to appropriate resolution partners. Maintain daily tracking and documentation of all Project activities and communications within the Data Control Tool. Show less

Reviewing and processing medical claims through research and adjustments staying up to date on latest healthcare changes to ensure accurate processing; maintain productivity and quality standards to insure the best possible customer service.