Job Details

Overview
Be the bridge between coverage and care

Manages and evaluates insurance claims to ensure accurate coverage and timely processing. Investigates claims, negotiates settlements, and responds to inquiries from claimants and related parties. Assists clients in submitting claims correctly and coordinates with internal teams to facilitate efficient claim resolution. Maintains detailed records and verifies claim compliance are key to supporting audit and regulatory requirements.

Responsibilities

Manage and evaluate insurance claims to ensure accuracy and timely processing

Investigate claims and negotiate settlements in accordance with policy guidelines

Respond to inquiries from claimants and other related parties in a timely and professional manner

Assist clients with accurate and complete claim submission

Coordinate with internal teams to facilitate efficient claim resolution

Maintain detailed records and ensure compliance with audit standards and regulatory requirements

Qualifications
Minimum Qualifications

High school diploma or equivalent required

2+ years of experience in insurance claims processing or related support

Working knowledge of insurance policies, coverage, and claim adjudication processes

Experience investigating, resolving, and following up on claim issues

Strong communication and customer service skills

Ability to maintain detailed records and ensure compliance

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