Claims Specialist

Job Summary

Working remotely on a full-time basis, the Claims Specialist will manage medical claims processing, ensuring compliance with coding standards and investigating claims while maintaining high accuracy and performance metrics.

Key responsibilities:

• Process and review medical claims, applying knowledge of coding and fraud detection
• Conduct thorough investigations of disability and life claims, documenting findings and decisions
• Collaborate with team members and other departments to streamline workflows and enhance service delivery

Required qualifications:

• Minimum of 4 years of medical claims processing experience
• Strong understanding of medical terminology and claims examining processes
• Proficiency in Microsoft Office programs, particularly Word, Excel, and Outlook
• Exceptional organizational skills and attention to detail
• Ability to work independently and make informed decisions with minimal supervision