Flexibility to work variable days and hours.Maintain a working knowledge of our clients’ requirements.Ensure privacy, confidentiality, and precision with all work.Document all claimant information, communications in CRM system.Practice all policies and procedures to PHI and HIPAA.Maintain and follow-up on pending files, as required by guidelines.Connect with applicants to guide them through the claim process.Review supporting documentation for accuracy.Responsible for researching and resolving escalated and complex claim issues in a timely manner.Adjudicate claims within guidelines ensuring the benefit eligibility is correctly determined.Claimant acknowledgement and establishment of new claims assigned daily.This position is responsible for the accurate review, input and adjudication of claims.This position will ensure compliance with client's program specifications and SaviLinx policies and procedures.
Operates with respect and integrity in every way earning the trust of employees and customers alike.Empowers creativity to bring forward innovative solutions, relentlessly striving to improve what we do.Creates an inspiring, passionate culture in the spirit of teamwork.Every single interaction is important and meaningful and demonstrates responsiveness to employees and customers.Customer Service Representative II (CSR II) Adjudicators.
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