This listing was posted on ApplicantPro, TalentPlusHire.
Medical Utilization Specialist
Location:
Montego Bay
Description:
Segoso Caribbean is a diverse BPO located in Montego Bay, Jamaica. We are recruiting Team Members who have experience in medical reports utilization review with US Health Insurance companies. Responsibilities: (The list of tasks is ILLUSTRATIVE ONLY and is not a comprehensive list of all functions and tasks performed by position.) Reviewing insurance claim forms and medical records for missing information and inaccuracies Working with patients to help them understand the changes they need to make to improve their health Meeting with health care providers to discuss medical cases and treatment plans Discussing cases with insurance companies to resolve coverage disputes Conducting investigations into claims that may be fraudulent or involve patient abuse or neglect Recommending changes to existing policies to improve coverage or lower costs for consumers Providing information to patients about their insurance benefits, including eligibility requirements for government programs such as Medicare or Medicaid Providing case management services to patients with chronic conditions to ensure that they receive appropriate care Recording and reporting on findings from reviews to medical staff, administrators, or attorneys
Company:
Segoso Caribbean
Posted:
May 15 on ApplicantPro, TalentPlusHire
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