Claims Liaison Specialist

Job description

Collaborate with internal teams to conduct training sessions and measure effectiveness of training. #LI-Hybrid - Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions. - Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements. - Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards. - Provide support for audits, appeals, and compliance-related activities - Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs. - Document all interactions, updates, and outcomes clearly in case management or claims systems. - Performs all other miscellaneous responsibilities and duties as assigned or directed Qualifications: - Associates degree and two years of related work experience; or equivalent combination of education and related work experience. - Effective written and verbal communication skill, including the ability to...