US Healthcare Claims Processors

Role Description
Review, investigate, and resolve provider inquiries via the ticketing system (OneHub)
Assist providers by clarifying payment determinations, claim status, and policy-related queries
Route or coordinate requests with adjustment/claims team when correction or reprocessing is required
Analyze claims to determine accurate payment or denial decisions as per policy and benefits
Apply appropriate benefits, edits, and pricing guidelines, including physician contract pricing
Maintain thorough documentation and follow up on pending provider requests
Handle a high volume of repetitive tasks efficiently while maintaining accuracy and compliance
Continuously improve productivity and achieve required quality and SLA targets
Adapt quickly to system updates, process changes, and new learning requirements
Uphold UST values - Integrity, Customer Centricity, Innovation, Collaboration, Excellence, Respect
Preferred Skills & Experience
Must be at least h...