Teams at Anasazi Medical Payment Solutions, Inc.

Process medical, dental, and vision claims by interpreting plan documents, determining eligibility, and adjudicating claims. Handle appeals, correspond with groups and members, maintain HIPAA/PII confidentiality, support quality assurance, train colleagues, and complete special projects while managing moderate claim complexity and financial risk.

Support operations team to ensure accurate system configuration, client communication, dashboard monitoring, workflow documentation, and operational performance improvement. Manage tickets, lead internal projects, analyze provider contracts and metrics, ensure HIPAA compliance, and deliver client-facing presentations to drive quality and efficiency.

Manage claim negotiations, appeals, and related documentation; evaluate settlement strategies; prepare and present settlement offers; ensure compliance with plan provisions, contracts, ERISA/ACA and No Surprises Act guidance; maintain accurate system records; communicate with internal and external stakeholders; identify risks and escalate; collaborate on process and template improvements.