Claims Processing Specialist

Job Summary

A company is looking for a Claims Specialist to join their team.

Key Responsibilities

• Review claims to determine coverage and ensure documentation aligns with policy provisions
• Process paper claims and enter them into the system for evaluation
• Handle claims dispositions and rectify issues to prevent delays

Required Qualifications

• 2+ years of experience in claims processing, insurance, or a related field
• Prior experience with paper claims processing and understanding of regulatory requirements
• Familiarity with utilization management (UM) processes
• Experience handling sensitive data in compliance with privacy regulations
• Strong organizational skills to manage multiple claims while meeting deadlines