Louisiana Licensed Claims Specialist
Job Summary
To support a high-volume health insurance claims operation, the remote Claims Specialist II will process and adjust medical claims, research claim issues, and determine Coordination of Benefits (COB) while ensuring compliance with HIPAA and company policies.
Key Responsibilities
- Process medical claims, claims edits, and claims adjustments accurately
- Research and determine the correct Coordination of Benefits (COB) for members with multiple insurance plans
- Investigate and resolve complex claims issues and discrepancies
Required Qualifications
- High School Diploma or equivalent
- Minimum 2 years of medical claims processing experience
- Claims processing experience is required
- Coordination of Benefits (COB) experience strongly preferred
- Experience determining primary vs. secondary insurance coverage
Complete Job Description
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