Aston Carter
A Day in the Role:
- The claims resolution department handles all claims that come through that don’t “process cleanly.” A lot of claims are processed automatically if they are 100% correct.
- The claims resolution team will review all of the claims that are not automatically processed due to something being off/incorrect or needing more information.
- They will get trained on the most basic type of claim edit first which is finding valid beneficiaries to match to the claim.
- Need to research certain things- example – maybe the same name or social security is different, make sure they are paying attention to those details Some staff will start to get trained on handling different claim edits.
Qualifications:
- Claims experience
Necessary Skills:
- Claims Processing | Insurance Claims | Health Care
