Claims Specialist

A company is looking for a Claims Specialist who will advocate for members and resolve complex claims issues. Key Responsibilities Resolve complex claims issues by investigating billing discrepancies and coordinating resolutions Coordinate benefits across various carriers, including Medicaid and Medicare Educate and empower members about their benefit plans and claims processes Required Qualifications At least 2 years of experience in healthcare, customer service, or claims Familiarity with plan documents, ACA guidelines, and various benefit programs Proficiency in MS Word and Excel Ability to analyze claims and identify root causes Experience mentoring team members and contributing to process improvements

May 20, 2025 - 20:20

A company is looking for a Claims Specialist who will advocate for members and resolve complex claims issues. Key Responsibilities Resolve complex claims issues by investigating billing discrepancies and coordinating resolutions Coordinate benefits across various carriers, including Medicaid and Medicare Educate and empower members about their benefit plans and claims processes Required Qualifications At least 2 years of experience in healthcare, customer service, or claims Familiarity with plan documents, ACA guidelines, and various benefit programs Proficiency in MS Word and Excel Ability to analyze claims and identify root causes Experience mentoring team members and contributing to process improvements