Investigate all non standard claim problems (25%) Investigates for COB and determine the primary payer (25%) Investigate and process adjustment requests (25%) Adjust claim payments resulting from duplicate payments, incorrect payee, etc. Recover expended funds for managed care plans System documentation of investigation results Training of Coordination of Benefits claim p

Maintains, confirms and secures referrals, authorization, or pre certifications required for patients to receive physician or medical services. Verifies the accuracy and completeness of patient account information. Maintains database of payer authorization requirements. Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicai

The Performance Improvement Specialist is responsible for supporting the management of multiple Performance Improvement projects from original concept through design and implementation, which are strategically focused and drive performance and financial results. This position has a significant impact on the division's ability to meet business expectations of those we serv