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Alivi TPA of Florida, LLC
This role involves the highly complex review and adjudication of medical claims, including advanced claim history analysis and the resolution of complex appeals and reconsiderations. The examiner will serve as a senior escalation point and subject-matter resource for intricate claim issues, supporting the claims team with guidance and training.
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The Senior Medical Claims Examiner is the highest individual contributor level within the Claims processing structure and serves as a subject-matter resource for complex claims, escalations, appeals/reconsideration and process-related issues requiring additional research, documentation review, or independent analysis.