Health Insurance Claims Specialist

As a key member of the team, you will be responsible for processing and managing health insurance claims to ensure accurate and timely payments to providers and clients. Your role will involve handling claim submissions, verifying eligibility, processing payments, and addressing client inquiries related to their health insurance claims.

- Process health insurance claims accurately and efficiently. - Verify member eligibility and benefits coverage. - Review medical documentation for completeness and accuracy. - Process claim payments to healthcare providers and members. - Communicate effectively with members, providers, and other stakeholders. - Maintain accurate records of claim processing activities. - Adhere to regulatory requirements and company policies. Qualification Required: - Bachelor's degree in a relevant field (e.g., healthcare administration). - Strong understanding of health insurance claim processing procedures. - Excellent attention to detail and accuracy. - Proficient in MS Office Suite. - Excellent communication and customer service skills. - Ability to manage multiple tasks and prioritize effectively. Additional Company Details: The company offers a competitive salary and benefits package, opportunities for career growth and development, a positive and supportive work environment, and the satisfaction of making a difference in the lives of clients. In a typical day, you will review claim forms, verify information, process payments, communicate with clients and providers, and ensure compliance with regulations.