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Claims Integrity & Quality Examiner

Molina Healthcare of Illinois

Molina Healthcare is seeking a detail-oriented claims support specialist to evaluate adjudication of claims, gather supporting records, and identify errors in coding and processing. You will manage a caseload, make recommendations, and help improve efficiency within the claims function. Responsibilities include meeting quality standards, handling multiple projects, and providing strong verbal and written communication, with proficiency in Microsoft Office. #J-18808-Ljbffr Molina Healthcare

Vacancy posted 4 days ago
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