Dalitza

Experiencia demostrada en Claims Analysis.

Experiencia demostrada en Medical Expense Reimbursement.

Experiencia demostrada en Pre-authorizations.

Experiencia demostrada en Insurance Policy Administration.

Experiencia demostrada en Client Support.

Analyze daily medical insurance claims to determine coverage and indemnity payments. Review policy terms, exclusions, and benefits to ensure accurate claim resolutions. Submit and manage pre-authorizations with multiple insurance carriers. Review rejection and return letters and communicate resolutions to clients. Provide support to internal teams, brokers, and external clients

Managed patient admissions across multiple hospital departments. Processed billing for emergency and surgical services. Handled national and international medical insurance claims. Verified copayments, deductibles, coinsurance, and non-covered expenses

Process and settle medical expense claims submitted to the brokerage. Notify clients regarding claim status, adjustments, and final resolutions. Verify correct application of payments and reimbursements. Resolve client inquiries related to medical claims

Análisis y gestión de reclamos de gastos médicos. Revisión de coberturas y exclusiones. Envío de preautorizaciones. Atención a clientes. Manejo de cargas masivas en sistema mediante Excel

Liquidación de reclamos médicos. Realización de ajustes. Notificación a clientes. Verificación de pagos. Asegurando procesos precisos y oportunos

Manejo de seguros nacionales e internacionales. Copagos. Deducibles. Coaseguros. Uso de sistemas de facturación y admisiones propios de la empresa

Apoyo administrativo médico. Manejo de expedientes. Atención al cliente. Cobro de servicios. Control de caja