Medical Claims Specialist

A company is looking for a Medical Claims Specialist.

Key Responsibilities

Review and analyze claim submissions and supporting documentation

Determine claim eligibility and calculate payment amounts

Maintain organized claim files and communicate decisions to stakeholders

Required Qualifications

High school diploma or equivalent required; Associate's or Bachelor's degree preferred

2+ years of claims processing or insurance industry experience preferred

Strong knowledge of claims adjudication procedures and regulatory requirements

Proficient in claims management software and Microsoft Office Suite

Experience with compliance awareness and customer focus