ComPsych® Corporation is the world’s largest provider of employee assistance programs (EAP) and is the pioneer and worldwide leader of fully integrated EAP, behavioral health, wellness, work-life, HR,FMLA and absence management services under its GuidanceResources® brand. ComPsych provides services to more than 31,000 organizations covering more than 82 million individuals throughout the U.S. and over 130 countries. By creating “Build-to-Suit” programs, ComPsych helps employers attract and retain employees, increase employee productivity and improve overall health and well-being. For more information, visit www.compsych.com.
The Claims Specialist determines the appropriate reimbursement for Managed Care claims and adjudicates each claim completely and accurately in accordance with company standards.
- Processes assigned managed care claims in accordance with accuracy and production standards.
- Applies the appropriate benefit and rates for each adjudicated claim.
- Corrects audit error within service standards.
- Responds to incoming inquiries, complaints and appeals and resolves issues for clients.
- Assists other specialists, examiners and claims logging, mail clerks and customer service department when workload dictates.
- Participates in special projects as assigned