Must be able to interpret provider contracts and read a DOFR (Division of Financial Responsibility)
* Must be able to identify trends and determine root cause analysis for claims related issues
*Must be able to work closely with internal departments to proactively resolve identified trends and systemic inaccuracies.
*Must research claims reports that are generated from the Finance and various departments.
* Previous claims examining experience preferred
*Mst have organizational and analytical skills
*Must have knowledge of medical terminology and procedures codes
* Must have excellent written and verbal communications skills.
be familiar with medical terminology
claims experience a must
customer service and data entry skills
be able to pass a background check and drug screening
This is more than just a statement – it’s how we do business. It is what sets us apart from everyone else in the industry. It’s not only what we look for in ourselves – it’s what we expect from every member of our team and the quality that we are looking for in you. So, if you’re an original thinker who’s passionate, dedicated, results-oriented and a true professional, you are our ideal candidate.
When you join the GLC team, you open the door to possibilities. We believe that recruiting isn’t just about finding you a job, it’s about offering you a career – allowing you to set your own goals and create your own success.
Our knowledge of the market is unparalleled and as a member of our team, these resources are made available to you. Our insight keeps us one step ahead, often offering positions before they are offered through any other source.
Learn more about our organization by connecting with one our team members and see why the GLC Group continues to set standards and deliver results.