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- ...facilities within the member’s network or option for home country treatment. •Adjudicates High Cost claims at submission level for settlement between the insurer and health care provider as per policy terms and conditions. •Adjudicates High cost claims at...
- ...established standard procedure. Responsible for more complex tasks, such as evaluating difficult or high-cost claims, determining settlements, managing escalated customer concerns, and offering mentorship and training to junior colleagues. Takes decisions on high cost...
