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Benefits Consultant 1
Ref No.: 18-27499
Location: Franklin, Tennessee
Manual and system claims audits to ensure proper claims adjudication.
Including Medicare fees schedules, benefit plans, claims editing.
Report and escalate issues to Quality Management and Team Leader.
Review and assesses appropriateness of document changes in accordance with internal procedures. Contributes to reviewing claims for adequacy of root cause, corrections, corrective actions, preventive actions and effectiveness.
Must be excellent problem solver and proactive solution seeker.
Ability to work in a fast paced environment.
Excellent attention to detail; sound judgment ; initiative and flexibility. Strong interpersonal communication and relational skills

Additional Job Details:
1-5 years Claims processing or auditing Medicare Supplement experience a plus.