Do you want to be a part of one of the largest, independent process transformation companies in the world Apply now as a USRN - Customer Service Associate here in Sutherland.
Job Description:
- Review medical records in relation to the services billed on claims
- Collaborate with Medical Directors to obtain determinations where medical necessity is unclear
- Coordinate referrals from non-clinical staff for clinical case reviews
- Ensure claims adhere to all regulatory requirements before final processing
- Handoff cases back to non-clinical staff for letter creation and claim adjustments
Minimum Qualifications:
- Active USRN license
- Basic knowledge of troubleshooting and computer navigation
- Background in clinical review or medical claims processing
- Willing to work onsite
