Healthcare Claims Specialist

Job Summary

A company is looking for a Healthcare Claims Specialist.

Key Responsibilities:

• Resolve medical claims that are not automatically adjudicated by the claims processing system
• Conduct additional investigation or communication to obtain necessary information for claim completion
• Review and interpret contract benefits, determine benefit eligibility, and resolve processing issues

Required Qualifications:

• High School diploma or equivalent
• Two years of college coursework or equivalent certification in a related field
• One year of related office experience in claims processing, health insurance, or medical office
• Experience with medical claims processing, preferably with AMISYS
• Ability to work in CST time and provide own equipment