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 or technically challenging issues
• 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
• Proven success in a high volume, production driven environment
• Demonstrated ability to manage multiple assignments with accuracy and efficiency
• High School Diploma required; preferred Associates degree or equivalent work experience