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$12
CLAIMS ANALYST
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Mostrado en español — traducción no disponibleGENERAL DESCRIPTION: Analyzes claims and/or adjustments submitted in CMS-1500 and UB-04 formats, as well as member reimbursements, by applying payment rules to determine appropriate adjudication, denial, or the need for additional information. This includes the review of original claims, adjustments, Coordination of Benefits (COB), and grievances from providers in Puerto Rico, non-participating providers, and providers in the United States, as well as reimbursement requests originating from countries outside the United States and Puerto Rico, up to the maximum adjudication authority limit established by current policies and procedures.
$12
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