Claims Specialist

Job Summary

A company is looking for a Claims Specialist I who will resolve medical claims that are not automatically adjudicated.

Key Responsibilities

• Process claims by entering data, reviewing contract benefits, and determining benefit eligibility
• Engage in continuous learning to stay updated on processing procedures and system modifications
• Perform additional duties as assigned

Required Qualifications

• High School diploma or equivalent
• Minimum two years of college coursework or equivalent certification in a related field, or one year of related office experience
• Must pass company proficiency test: Claims Assessment
• Knowledge of anatomy, medical terminology, math, or biology is preferred
• Ability to maintain the security and confidentiality of records and information