Claims Analyst Representative
Health Plan of Nevada - United Health Group - Las Vegas Nevada
- Effectively analyzed and coordinated benefits for payments on health claims.
- Processed coordination of benefit claims.
- Maintained the company's production and quality standards.
- Precisely evaluated and verified benefits and eligibility.
- Investigated medical records to determine pre-existing medical conditions.
- Performed other office duties as needed.
- Denied all incorrect claims submissions.
- Reviewed medical claims submitted as an appeal.
- Researched each claim and paid according to specified benefit contracts.
- In-depth knowledge of medical insurance and medical terminology.
- Ensure the coverage and figure the payment amount for each claim.
- Ability to understand insurance contracts.
- Proficiency with computer platforms and applications.
- Knowledge of COB & EOB.
- Ability to process Professional & Facility Claims.
- Knowledge of Facets and Macess Medical Platforms.