• Manage the insurance claims process • Provide customer service to clients • Analyze and approve claims that cannot be adjudicated • Determine coverage and applies medical necessity guidelines • Identify and clarify any discrepancies to assist in the adjudication process • Ensure accurate and timely processing of rejected claims • Work directly with third party payers for claim resolution • Communicate with facilities on claim issues • Resolve discrepancies and secure proper reimbursement • Follow federal and state regulations • Adhere to company policies and procedures • Follow HIPPA guidelines and regulations