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Claims Processing Specialist
3 months ago
As a Claims Processing Specialist, you will oversee the daily administration of claims operations.
Key Responsibilities
1. Manage routine claims processing tasks efficiently.
2. Ensure workflow coordination to meet established deadlines.
3. Assess claims for eligibility based on defined criteria.
4. Make informed decisions on complex and high-cost claims following standard procedures.
5. Handle international preauthorization requests as necessary.
6. Respond to inquiries from insurance companies, clients, and healthcare providers via calls and emails.
7. Collaborate with international providers to facilitate direct billing processes.
8. Propose enhancements to improve service delivery.
9. Strive to increase operational efficiency, reduce errors, and minimize administrative time.
Behavioral Competencies
- Strong organizational and time management abilities.
- Capacity to interact effectively with all levels of internal management and external clients.
- Demonstrated commitment to ethical work practices.