GRG’s Medical Monitoring and Consulting is a service-oriented business unit responsible for the administration of medical appointments and claim payments. Associates will work with internal and external stakeholders to deliver an excellent experience to all customers.
Responsibilities and Duties
Claims Administration – Accurately and efficiently performs claim intake, adjudication, payment, and generation of provider and class member correspondence (e.g., explanation of payment and explanation of benefits).
Program Liaison – Coordinates with other business units (enrollment, call center and payment teams) to achieve positive program results. Associates must ensure that program-related inquiries are managed accurately and timely.
Claims Software Application – Serves as subject matter expert for all claims-related software applications.
Claims/Financial Reporting and Appointment Reporting – Generates required program reports accurately and on-time.
Software User Acceptance Testing – Participates in user acceptance testing of the enterprise application under the direction of the MMC Operations Manager.