Healthcare Claims Specialist

1 week ago


Chicago, Illinois, United States General Search & Recruitment Full time
Job Summary

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.
Qualifications
  • 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.
Compensation and Benefits
  • 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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