Senior Claims Benefit Specialist

Job Summary

A company is looking for a Senior Claim Benefit Specialist - Remote.

Key Responsibilities

• Review and adjudicate complex medical claims according to established guidelines
• Provide coaching and guidance on escalated claims and customer inquiries
• Ensure compliance with regulatory requirements and identify claim irregularities

Required Qualifications

• Minimum of 18 months of medical claim processing experience with a health insurance payor or third party administrator
• Experience in a high volume, production-driven environment
• Ability to manage multiple assignments with accuracy and efficiency
• High School Diploma required
• Preferred Associates degree or equivalent work experience