Healthcare Claims Specialist
1 week ago
We are seeking a skilled Claims Specialist to oversee all aspects of file handling for healthcare claims, including property claims. The ideal candidate will have a strong background in claims management and excellent analytical and communication skills.
Key Responsibilities- Direct and manage all aspects of file handling for healthcare claims, including property claims.
- Review potential and excess files to assess the need for ongoing claims management.
- Analyze and determine coverage, initiate claim investigations when necessary, and assess overall claim handling requirements.
- Maintain clear and prompt communication with internal and external stakeholders.
- Collaborate effectively as part of a team while also demonstrating the ability to independently manage a claims desk.
- Multitask efficiently and remain self-motivated, showcasing strong organizational and time management skills.
- Apply analytical thinking, advocacy, and negotiation skills to claims resolution.
- Be open to occasional travel for mediations, settlement conferences, and client/account meetings (approximately 10% of the time).
- Ensure compliance with adjusters' license requirements in assigned states or the ability to obtain such licenses.
- Bachelor's Degree is required.
- A minimum of 5 years of claims or relevant experience, preferably in healthcare liability/medical malpractice claims.
- Detail-oriented with a strong aptitude for technical, analytical, strategic, and decision-making skills.
- Adaptability to work effectively both as part of a team and independently.
- Demonstrated ability to multitask and remain self-motivated.
- Exceptional organizational and time management abilities.
- Strong analytical thinking, advocacy, and negotiation skills.
- Willingness to travel as needed (up to 10%).
- Ability to maintain valid adjusters' license(s) in assigned states or obtain them.
- Competitive base salary ranging from $85,000 to $100,000, commensurate with experience.
- Performance-based incentives.
- Comprehensive benefits package.
- Hybrid work arrangement (2 days a week in the office) in a dynamic and vibrant work environment.
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