Claims Specialist

Claims Specialist needs 1 year claims system experience, preferably in the Healthcare industry

Claims Specialist requires:

• College degree or equivalent experience required
• Minimum of 1 year claims system experience, preferably in the Healthcare industry
• Basic analytical and problem solving skills
• Good communication and interpersonal skills
• Ability to work independently and with others
• Ability to manage more than one assigned tasks at the same time

  Claims Specialist duties:

  • Responsible for setting up new Managed Care groups in the claims system Responsible for fulfilling requested revisions to existing Managed Care group in the claims system (except Reseller product changes) Responsible for creating standard
  • products in the system (using the Product Key Sheet method) Responsible for performing audits on client setup or maintenance requests (excludes complex product configuration requests) Follow the established corporate and industry audit controls (i.e. SOX, SSAE 18, etc.) when fulfilling setup and maintenance requests Resolve client structure setup questions/issues sent to the team with minimal supervisor guidance Maintain relationships with Implementation Managers and Account Managers to facilitate fulfillment of implementation questions and requests in a timely manner