Claims Specialist
New
This role is a remote role. This means you will be expected to work from your home, within the continental US.Full-TimeEntry
Salary$37,000-$43,680
Apply NowOpens the employer's application page
Job Details
- Languages
- Fluency in Spanish with the ability to translate documents (if applicable to this position)
- Experience
- 1 year of work experience
- Required Skills
- Customer serviceMicrosoft OfficeTime ManagementData entry
Requirements
- High School Diploma or Equivalent.
- 1 year of work experience.
- Proficiency using Microsoft Office Suite software.
- Knowledge of customer service principles, needs assessment, and quality standards.
- Knowledge of administrative and clerical procedures, including file and record management.
- Ability to interpret medical terminology and coding.
- Strong attention to detail and ability to understand implications of new information.
- Ability to perform mathematical calculations to solve problems.
- Effective time management skills.
- Fluency in Spanish (if applicable to the specific position).
Responsibilities
- Review and process Wellness, Accident and Vision insurance claims.
- Determine nature and validity of claims by reviewing policy status, patient eligibility, and supporting documentation.
- Key claims data while interpreting coding and medical terminology.
- Use multiple core administration databases, systems and subsystems to process and transmit claims.
- Provide prompt customer service to policy holders, providers and internal entities regarding claims.
- Document phone calls and follow-up on issues as needed.
- Contact insured persons to verify accuracy and completeness of claim forms.
- Provide back-up coverage for other teams, maintain databases, and prepare information using software systems.
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