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Claims Specialist Job
Full Job Title:
Claims Specialist I
Researches and processes institutional and/or professional claims.
Processes claims that pend for various hold reasons to assist in the final determination on claim disposition.
Processes adjustments related to projects or provider disputes.
Researches post payment claims issues and takes necessary action for correction.
Research claims issues and works with other departments to resolve claim issues.
Assists with special projects as assigned or directed.
Arizona representatives may provide provider phone coverage two days a week
Required A High School or GED
Preferred 1 year of experience in Previous claims or health insurance
Beginner Ability to multi-task
Beginner Ability to work independently
Beginner Ability to communicate and make recommendations to upper management
Intermediate Demonstrated interpersonal/verbal communication skills
Beginner Demonstrated written communication skills
Beginner Demonstrated analytical skills
Beginner Demonstrated problem solving skills
Beginner Demonstrated time management and priority setting skills
Beginner Demonstrated organizational skills
Beginner Knowledge of healthcare delivery
Licenses and Certifications:
A license in one of the following is required:
Required Beginner Microsoft Outlook
Required Beginner Microsoft Word
Required Beginner Microsoft Excel
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Last Updated On: 12/9/2015