Claim Examiner // Orlando FL 32822

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at http://www.mindlance.com. Business               Claim Examiner Visa                        GC/Citizen Location                 6272 Lee Vista Blvd, Orlando FL 32822 Division                  Pharmaceutical Pay                          Negotiable Contract                 6 Month Timings                  Mon - Fri between 8.00AM – 5.00PM POSITION OVERVIEW · Verify member submitted claims forms, member's eligibility & pharmacy information is complete & accurate, updating system information as needed. · A high data entry proficiency is expected in order to provide accurate & timely processing of claims submitted by member, pharmacy or agencies. · Moderate knowledge of drugs & drug terms used daily. · Process claims according to client specific guidelines while identifying claims requiring exception. · Navigate daily through several platforms to research & finalize claim submissions. · Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues. · Adhere to strict HIPPA regulations especially when communicating to others outside of ESI. · Prioritize & coordinate influx of daily workload for claims processing, returned mail & outgoing correspondence & e-mails to assure required turnaround time is met. · Assess accuracy of system adjudication & alert management of potential problems affecting the integrity of claim processing. · Analyze claims for potential fraud by member or pharmacy. · May be required to work on special projects for claims team. If you are available and interested then please reply me with your “ Chronological Resume” and call me on (678)-405-3590 . Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W : 678 405 3590 ranadheerm@mindlance .com