Healthcare Claims Specialist

Job Summary

A company is looking for a Claims Specialist (Healthcare).

Key Responsibilities

• Oversee the entire claims process ensuring accuracy, quality, and timeliness for all healthcare claims
• Conduct training for the global team on claims processing and manage complex issues/claims
• Monitor and report on client response files and claims process, ensuring all parties are updated on program status

Required Qualifications

• 5+ years of work experience in healthcare claims processing with in-depth experience with payor systems
• Strong knowledge of healthcare data and processes
• Subject Matter Expert (SME) on healthcare claims payment methodologies
• Ability to identify and resolve issues related to claims processing
• Demonstrated ability to implement process improvements for efficiency