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Senior Associate-Back Office-Customer Service

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  • Handle complex healthcare cases such as claims rework, provider appeals, and documentation analysis with minimal supervision.
  • Retrieve supporting documents from various systems, create appropriate case files, and ensure accurate attachment and classification.
  • Analyze each case to determine resolution or escalation to Subject Matter Experts (SMEs).
  • Implement SME guidance to complete case processing effectively and accurately.
  • Generate customer communication letters and ensure timely dispatch as per process requirements.

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