Transaction Quality Assurance Analyst

Location

Tennessee | United States

Job description

• In this Role you will be Responsible For

• Reviewing and researching insurance claims to determine possible payment accuracy.
• Validating Member, Provider and other Claims information.
• Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
• Coordinating Claim Benefits based on the Policy & Procedure.
• Scrutinizing Medical Claim Documents and settlements
• Auditing claims to measure the resolution provided during adjudication of the claims

Job tags

Salary