Claims Adjudication Specialist

This role provides support for provider claims adjudication activities, including responding to provider inquiries and ensuring the appropriate resolution of claim issues. The specialist collaborates with various operational teams to address claims paid incorrectly and manages defect reduction by identifying error issues. The position requires researching claims tracers, adjustments, and resubmissions while adjudicating high volumes of claims in a timely manner. The role also involves supporting department initiatives to improve overall claims function efficiency.