Insurance Claims Specialist
2 weeks ago
Insurance Claims Specialist
Company Overview: BCforward is a prominent firm dedicated to delivering exceptional professional services and workforce management solutions to organizations globally.
Position Overview: We are seeking a dedicated Insurance Claims Specialist to join our team. This role involves managing a diverse range of claims and ensuring effective communication with various stakeholders.
Key Responsibilities:
- Engage professionally with attorneys, insurance adjusters, medical providers, and clients through calls and correspondence.
- Maintain comprehensive case files with accurate notes from initiation to resolution.
- Provide timely and precise information to facilitate the progression of cases through the management workflow.
- Conduct daily communications with counterparties, including legal and healthcare professionals.
- Handle high-value cases independently, guiding them through to settlement.
- Verify third-party liability and conduct thorough research on probate and beneficiary assets.
- Draft necessary documentation, including correspondence, claims, and liens to advance cases towards recovery.
- Negotiate settlement amounts in accordance with established guidelines.
- Address and resolve claim disputes in collaboration with attorneys and relevant parties.
- Perform follow-ups on case statuses and payments.
- Review documents to ascertain current case status and ensure progress through the workflow.
- Prioritize critical case events and manage revenue-impacting deadlines.
- Analyze case information from multiple sources to draw informed conclusions.
- May provide guidance to junior claims examiners.
- Undertake other assigned tasks as necessary.
- High School Diploma required.
- Experience in a legal or insurance environment is advantageous.
- Proficiency in Microsoft Office Suite is essential.
- Familiarity with Medicaid and Medicare is preferred.
- Bilingual candidates (Spanish & English) are encouraged to apply.
- Strong attention to detail and accuracy.
- Ability to manage multiple tasks and prioritize effectively.
- Excellent communication skills, both verbal and written.
- Ability to work independently and collaboratively within a team.
- Commitment to maintaining confidentiality and ethical standards.
- Primarily office-based with sedentary tasks.
- May require occasional lifting and moving of objects.
- Flexibility to work extended hours as needed.
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