Productive and Fast Paced Claims Resolutions.
Pros: working as flexible schedule core schedule as a telecommuter processing caims to members/providers.
Cons: metrics/goals difficult to meet on a daily basis.
A typical day at work Fast Paced Review and Research of Medical Complex Claims and Adjustments in an Electronic Queue, Including Medical, Medicare, Medicaid-OPS-Out Patient Revenue and CPT Codes, ICD-9 Diagnosis Codes Sending out Electronically System Generated Informational and Overpayment Letters.
The Most Difficult part of this Job was the Goals/Metrics – more... to be met Daily were very difficult to Meet due to the volume and extent of Research on each individual Claim Issue.
The Most Enjoyable part of the job was taking Great Pride in the Completion and Resolution of each and every Claim Issue to be able to Assist both the Member's and Providers on a Daily Basis.
Working as A Telecommuter Claims Processor and Claims Adjuster, Quality Analyst, We were not able to Meet our Co-Worker's Face to Face, only speaking to Our Team Members and Supervisors, Business Managers via Conference Call or Web-Ex Meeting and Training Demonstrations. – less