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Showing posts with the label Fraud Investigator

Medical Claims Processing Executive

Company: AXA General Insurance Determines covered medical insurance losses by studying provisions of policy or certificate. Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims. Documents medical claims actions by completing forms, reports, logs, and records. Provide clients with information on incomplete form entries and assist them in locating avenues to obtain them. Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. Provide clients with information on incomplete form entries and assist them in locating avenues to obtain them. Perform follow-up services to ensure that all unpaid and selective denied claims are paid in an accurate and timely fashion Ensures legal co...

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