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Claims Compliance Analyst, Full-Time, Days
Maintains positive working relationships with our internal and external customers, health plan’s, providers and/or members by seeking a partnership approach that will meet the company goals and vision. The Claims Compliance Analyst will coordinate Health Plan’s audits activities with preparation and provide preliminary results on non-compliant claims to the Claims Director. Assists with an audit control checklist for prevention of claims untimeliness of payment. Collaborates in conjunction with the Managed Care Management Team and other auditors, to ensure QA programs are aligned with claims operations and other areas that have direct impact with claims to prevent non-compliance. Adheres to
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