Re-pricing claims specialist - (Nashville, TN)

Re-Pricing Claims Specialist! Apply Now! Required responsibilities: Re-Price medical claims using PPO Network's online systems/tools Resolve re-pricing disputes from Providers/Members Re-Price claims based off client's contract terms Research medical claims, operational and customer service issues and make recommendations for resolution Maintain an adequate daily production Pricing rate with acceptable defects as determined by Supervisor Monitor all reports, emails, and call tracks routed to the Cost Management team Monitor time service on claims sent via EDI to pricing vendors Monitor and analyze, as needed, key indicators within the Pricing process Coordinate the timely release (DOL) of all claims in the Pricing inventory Resolve issues with claims that are edit/kicked out of the standard process Expertise to re-key claims in PPO network re-pricing tools Route claims to other departments with clear and precise notes Generate reports of position assignments and production results to management team Be able