Claims Specialist

Job Summary

A company is looking for a Claims Specialist to review and analyze medical, vision, and dental claims.

Key Responsibilities

• Review, analyze, and determine payment, partial payment, or denial of claims based on client plans
• Document information in the QicLink System and ensure compliance with privacy and security laws
• Consult with professionals and interview claimants for additional information regarding claims

Required Qualifications

• High School Diploma required; College education preferred
• Minimum of five years of medical claims analysis and adjudication experience
• Strong analytical skills and knowledge of CPT and ICD-10 coding terminology
• Desire to assist the team in exceeding established goals
• Prior experience in Adjustment Processing is preferred but not required