Claims Review Specialist
Job Summary
Working remotely in a full-time capacity, the Claims Review Specialist will assist clients by answering inquiries and resolving issues related to claims, while performing research to ensure accurate responses and maintaining a comprehensive understanding of relevant plan documents.
Key responsibilities
- Review and analyze claims processing and eligibility based on plan documents
- Provide timely customer service by responding to inquiries and resolving urgent issues within established timeframes
- Conduct self-quality monitoring and collaborate with teams to improve procedures and meet quality standards
Required qualifications
- High School Diploma or equivalent
- At least 2 years of experience as a claims examiner and/or in customer service
- Proficient 10-key and typing skills
- Demonstrated self-motivation and organizational skills
- Ability to maintain confidentiality and remain neutral in communications
Complete Job Description
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