Conduent State Healthcare, LLC

Compensation

Full Description

Job Title: Medical Benefit Review Services Associate - Region 3 Company Overview: Conduent State Healthcare, LLC is a leading provider of healthcare solutions, partnering with Fortune 100 companies and government agencies to deliver mission-critical services. We are committed to creating exceptional outcomes for our clients and the millions of people who rely on our expertise and dedication. Role Overview: As a Medical Benefit Review Services Associate, you will play a vital role in reviewing and managing medical benefit claims to ensure accuracy and compliance. This position is essential in supporting healthcare operations and improving service delivery for our clients in Region 3. What You'll Do: - You will review medical benefit claims for accuracy and completeness. - You will analyze medical documentation to verify eligibility and coverage. - You will communicate with healthcare providers and clients to resolve discrepancies. - You will ensure compliance with regulatory and company policies. - You will maintain detailed records of claim reviews and decisions. - You will collaborate with team members to improve review processes. - You will assist in training new associates on review procedures. - You will contribute to quality assurance initiatives to enhance service delivery. What You Bring: - Minimum of 2 years experience in medical claims review or healthcare administration. - Strong knowledge of medical terminology and healthcare benefit plans. - Excellent analytical and problem-solving skills. - Proficient in using healthcare management software and Microsoft Office. - Effective communication skills, both written and verbal. - Ability to work independently and as part of a team. Bonus Points If You Have: - Experience with Medicaid or Medicare claims processing. - Certification in medical billing or coding. - Familiarity with regulatory compliance standards such as HIPAA. - Prior experience in a customer service role within healthcare. What We Offer: - We offer competitive salary and comprehensive benefits package. - We offer opportunities for professional growth and development. - We offer a supportive and inclusive work environment. - We offer flexible work schedules to promote work-life balance. - We offer employee wellness programs and resources. Ready to Apply? To join our team as a Medical Benefit Review Services Associate, please submit your resume and cover letter through our online application portal. We look forward to reviewing your application and exploring how you can contribute to our mission of delivering exceptional healthcare services.