Claims Specialist

About the job 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