Process enrollment requests and create complete, accurate case records to support timely downstream claim support activity.
First line team member to identifying Adverse Events
Complete Tier 1 claim reviews using program business rules, identifying missing information, obvious coding or submission issues, and the next best action for the provider.
Conduct benefit verification and basic payer outreach activities, as assigned, to confirm coverage requirements or obtain clarification needed to move cases forward.
Document all actions, outcomes, and communications clearly in the program CRM to ensure continuity and visibility across teams.
Identify cases that require higher level review and route or escalate to the appropriate US Case Manager, Supervisor, or program leadership per defined workflows.
Support seasonal surge readiness by maintaining queue discipline, meeting turnaround expectations, and flex...
Ready to Apply?
Join thousands of Americans building their careers