Overview

The Medical Claims Officer will provide quality service to clients, promptly and effectively assess and process OP claims according to operations set standards.

Main Responsibilities / What to Do

• Manage routine daily claims administration work.
• Coordinate workflow and meet deadlines.
• Evaluate OP claims with regards to eligibility.
• Apply Nextcare cost containment protocols for OP claims at the retrospective review level.
• Attend calls and emails from insurance companies, clients, and providers.
• Make suggestions to improve service.