Claims Intake Specialist

Job Summary

Responsible for reviewing and determining claim requirements, the full-time Claims Intake Specialist will assist Care Managers and Care Coordinators while providing quality customer service to policyholders and their representatives.

Key responsibilities

• Review internal databases, client guidelines, and policy contract language to determine claim requirements for initial and continuation claims
• Contact insured individuals, their representatives, or providers to request information needed for processing benefit inquiries
• Maintain clear documentation of all claim intake activities within required databases and meet established quality and production metrics

Required qualifications

• High school diploma or equivalent
• Experience in customer service or claims processing preferred
• Familiarity with insurance policies and procedures is a plus
• Ability to work with internal databases and documentation systems
• Strong organizational skills and attention to detail