Transaction Quality Assurance Analyst

In this Role you will be Responsible ForReviewing and researching insurance claims to determine possible payment accuracy.Validating Member, Provider and other Claims information.Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure.Coordinating Claim Benefits based on the Policy & Procedure.Scrutinizing Medical Claim Documents and settlementsAuditing claims to measure the resolution provided during adjudication of the claims