Claims Specialist

Job Summary

Processing and reviewing routine life and health claims, the full-time remote Claims Specialist will analyze claims, respond to inquiries, and ensure accurate data entry while adhering to compliance regulations.

Key responsibilities

• Review, analyze, and process routine life and health claims, including adjustments and coordination of benefits
• Respond to inquiries from agents, policyholders, and providers regarding policy coverage and related information
• Cross-train on additional products and assist with related duties such as medical records and provider files

Required qualifications

• General knowledge of claims processing principles and insurance-related policies
• High school diploma or GED equivalent
• Previous related experience is a plus
• Intermediate computer skills with basic knowledge of MS Office Suite
• Ability to meet procedural, financial, and quality metrics, including compliance regulations