Boston, MA - Nov 17
Job Description Serves as primary liaison for claims resolution. Provides phone coverage for providers to answer/resolve incoming inquiries regarding claims adjustment requests. Handles special projects and performs research as needed. Ã? Key Functions & Responsibilities: Ã? Responds to provider phone calls and correspondence including but not limited to, claim adjustment requests, appeals, corrected claims, timely filings, and claims projects. Maintains current knowledge of BMCHP benefits, provider network development and contract issues, HIPAA regulations, Massachusetts Medicaid regulations, as well as industry standards for claims adjudication and other party liability issues. Adheres to HIPAA guidelines. Reports problems and trends to Manager of ...
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