Responsible for analyzing data for statistical reports, maintaining databases, extracting data, and supporting operational functions through report generation and analysis.

Responsible for maintaining provider files, generating reports, resolving eligibility issues, and contributing to projects related to healthcare service providers.

Supports the claims department by managing communications, processing claims submissions, and providing customer service to clients. Coordinates with reinsurance entities and maintains documentation.

Lead and coordinate audit reviews, mentor staff, prepare reports, and ensure compliance with auditing standards while managing audit workflows.

Responsible for maintaining healthcare provider files, ensuring timely claims processing, and supporting provider directories. Involves verifying information and contributing to special projects.

Responsible for reviewing and processing provider enrollment applications, ensuring compliance and maintaining provider file integrity. Communicates with customers and resolves discrepancies.

Responsible for processing provider enrollment applications, ensuring compliance with guidelines, and providing quality service to customers while assisting with records management and process improvements.

Responsible for processing claims accurately and timely, resolving errors, and coordinating with internal departments to maintain records.

Responsible for conducting internal and external audits, evaluating controls, identifying risks, drafting reports, and leading audit teams. Ensures compliance and presents findings to management.

Responsible for identifying training needs, developing materials, facilitating training, and managing trainee performance while providing guidance for new training specialists.