Claims Liaison Specialist

• Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.
• Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.
• Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
• Collaborate with internal teams to conduct training sessions and measure effectiveness of training.
• Provide support for audits, appeals, and compliance-related activities
• Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.
• Document all interactions, updates, and outcomes clearly in case management or claims systems.
• Performs all other miscellaneous responsibilities and duties as assigned or directed

#LI-Hybrid