This position is crucial in ensuring the efficiency and accuracy of claims processing within the department. The primary goal is to prevent the aging of claims and to avoid erroneous disbursements or claims processing errors. The role involves a significant amount of research to verify disbursement requests, ensuring that they are valid and properly documented. This includes investigating rejected, transitioned, and paid status claims for validity and escalating issues as necessary. The position requires a thorough understanding of the various systems used within the department and the company to complete research effectively, as well as a comprehensive knowledge of the claims system and its interrelation with other systems. In addition to verifying disbursement requests, the role entails researching claims to identify or validate instances of fraud, waste, or abuse. Monitoring inventory reports is also a key responsibility, ensuring that claims are resolved in a timely manner. The position may require providing documentation for audit purposes and communicating with stakeholders through written or telephone correspondence to resolve claims issues. Furthermore, the role involves researching claims related to billing or crediting groups, ensuring that proper adjustments are made and that groups receive appropriate credit or billing. Overall, this position plays a vital role in maintaining the integrity of the claims process, supporting departmental goals, and assisting with any special projects that may arise.