Claims Payables Specialist

Your Opportunity As a Claims Payables Specialist, you play a pivotal role in the processing and adjudication of value-based care claims, ensuring they comply with both internal policies and regulatory standards. Your focus is on maintaining the integrity and accuracy of claims payments, contributing to the efficiency and reliability of our healthcare reimbursement model. This role requires meticulous attention to detail, a thorough understanding of value-based care agreements, and a commitment to continuous improvement in claims processing. By collaborating with various departments and managing provider relationships, you will ensure claims are processed accurately and efficiently, supporting the financial health of our organization and the satisfaction of our providers. What you will do - Process and adjudicate value-based care claims in accordance with established policies, procedures, and regulatory requirements. - Review processed claims for accuracy, completeness, and compliance with contractual agreements and reimbursement guidelines. - Investigate and resolve discrepancies or discrepancies in claim information, working collaboratively with internal and external partners as needed. - Ensure timely and accurate payment of value-based care claims, including the calculation and application of appropriate reimbursement rates and adjustments. - Maintain thorough and accurat...