Claims Representative

Job Summary

Working remotely on a full-time basis, the Claims Representative will provide expertise in reviewing, researching, investigating, negotiating, processing, and adjusting claims to ensure accurate payment and resolution of issues.

Key responsibilities

• Research and obtain necessary data to process claims and resolve issues, ensuring proper benefits are applied
• Identify and resolve claims processing errors and collaborate with internal and external stakeholders to address issues
• Document and communicate the status of claims and investigations, adhering to reporting requirements and achieving performance metrics

Required qualifications

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 1+ years of healthcare experience
• Ability to work Monday - Friday, 8:00 am - 4:30 pm CST, with flexibility for occasional overtime