Medical Claims Representative

Job Summary

Investigating and evaluating medical only claims, the full-time Medical Claims Representative will work remotely to verify coverage, communicate with customers, and manage the claims process effectively.

Key responsibilities

• Investigates and evaluates medical only claims across multiple jurisdictions
• Contacts customers to obtain information and explains the claims process
• Documents claim handling activities and maintains accurate records to ensure timely resolutions

Required qualifications

• Associate degree or equivalent relevant experience
• One year of insurance or claims handling experience, or related experience
• Bachelor's degree may be considered in lieu of the experience requirement
• Attainment of all applicable state licenses within six months of hire