Senior Executive - Claims Audit
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Job description: • Review and analyze medical records and claims data to ensure accuracy, completeness, and compliance with healthcare regulations and payer requirements. • Verify that all necessary clinical documentation is included to support claim submissions and medical necessity. • Identify and resolve inconsistencies, errors, or missing documentation in patient records or claims. • Prioritize and manage workloads to ensure expedited and high-priority cases are...
- Analytical Ability To Work Independently
- Claim Verification
- Communication Skills