Investigates and processes claims episodes based on claims information submitted by provider and departmental policies and procedures. Reviews, investigates and adjudicates claims for medical, facility, home health care, hospice and vision services which involve the application of contractual provisions in accordance with provider contracts, authorizations and Medicare regulations. Processes claim suspensions from the system to correct processing discrepancies and other edits by reviewing ...
Metropolitan Jewish Health System - 30+ days ago
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