Claims Representative

Job Summary

A company is looking for an Associate Claims Representative to handle claims adjudication and adjustments remotely.

Key Responsibilities:

• Update claim information based on research and communication from members or providers
• Complete necessary adjustments to claims and ensure proper benefits are applied using appropriate processes and procedures
• Communicate extensively with members and providers regarding adjustments to resolve claims errors or issues

Required Qualifications:

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 1+ years of experience in a related environment (e.g., office, administrative, customer service)
• Ability to use computers and Windows PCs, including keyboard and navigation skills
• Ability to work full-time (40 hours/week) during normal business hours with flexibility for occasional overtime or weekends