Insurance Claims Specialist

📋 Description

• Review and process incoming claims in accordance with company policies, guidelines, and regulatory
• Accurately enter claimants’ insurance data into claims processing systems.
• Analyze claim information, supporting documents, and medical records to determine accuracy and
• Identify discrepancies or missing information and follow up with providers, employers, or claimants
• Apply medical knowledge to interpret clinical notes, treatment plans, medical terminology, and
• Ensure timely adjudication and maintain productivity and quality expectations.

🎯 Requirements

• Minimum of 4 CXC Subjects including English A
• Minimum of 1+ years of claims processing experience in medical claims entry, billing or a related
• Familiarity with medical terminology and comfort reviewing medical records or clinical
• Familiarity with U.S healthcare system, insurance terminology and claims processing.
• Strong analytical and critical-thinking skills with high attention to detail.
• Excellent written and verbal communication skills.