Claims Specialist
Job Summary
To support a mission of simplifying healthcare, the full-time remote Claims Specialist will resolve complex claims issues, coordinate benefits across various carriers, and educate members on their benefit plans.
Key responsibilities
- Investigate billing discrepancies and coordinate resolutions among members, carriers, and providers
- Manage cases involving Medicaid, Medicare, and other benefit programs to ensure proper coordination
- Guide members through their benefit plans and assist them in navigating challenging claims scenarios
Required qualifications
- At least 2 years of experience in healthcare, customer service, or claims
- Familiarity with plan documents, ACA guidelines, Medicare, and COBRA
- Proficiency in MS Word and Excel, with comfort in using internal databases
- Strong analytical skills for identifying root causes of claims issues
- Ability to maintain a private, HIPAA-compliant workspace for handling sensitive information
Complete Job Description
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