Claims Specialist

Responsibilities: Investigate and resolve complex healthcare billing discrepancies and coordinate benefits across various carriers. Educate members on their benefit plans and guide them through challenging claims scenarios to ensure timely resolution.

Requirements: Requires at least 2 years of experience in healthcare, customer service, or claims. Candidates must have a private, HIPAA-compliant remote workspace and proficiency in MS Office.

Key skills: Claims Resolution, Healthcare Advocacy, Benefit Coordination, Billing Investigation, Member Education, HIPAA Compliance, MS Word, MS Excel, Problem Solving, Empathetic Communication, Case Documentation, Root Cause Analysis

Keywords: Healthcare, Claims Specialist, Medicaid, Medicare, ACA Guidelines, COBRA, Dental Benefits, Vision Benefits, Behavioral Health, HIPAA, Benefit Plans, Claims Processing, Customer Service, Case Management, Remote Work