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Claims Specialist Job Description
Researches and processes institutional and/or professional claims.
Essential Functions:
- Processes claims that pend for various hold reasons to assist in the final determination on claim disposition.
- Processes adjustments related to projects or correspondence.
- Researches post payment claims issues and takes necessary action for resolution
- Researches and processes all of the following work types:
- Case Logs
- Analyzers
- Manuals
- Hospital Audits
- Appeals
- Web Inquiries
- Assists with special projects as assigned or directed.
Claims Specialist Qualifications
- Education: High School diploma required
- Experience: 1 – 2 years previous claims or health insurance experience preferred
- Technical Skills/Requirements: Familiarity with Microsoft Office including Outlook, Word and Excel
Primary Location: FL-Tampa
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