Claims Research Specialist

Job Summary

A company is looking for a Claims Research Specialist to act as a liaison in investigating and resolving claims inquiries.

Key Responsibilities

• Receive and respond to internal and external claims-related issues
• Complete claims-related research projects and assist with data integrity of provider claims processing systems
• Educate provider relations and services regarding policies and procedures related to claims submission

Required Qualifications

• High school diploma or equivalent; Bachelor's degree preferred
• 3+ years of experience in claims payment processing in government programs
• Experience in a managed care environment
• Knowledge of claims billing and processing functions and Medicaid benefits
• Experience in customer service