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Insurance Claims Specialist | Patient Financial Services | Onsite (Hybrid Potential)
Be the bridge between coverage and care.
As an Insurance Claims Specialist, you play a critical role in ensuring claims are processed accurately, efficiently, and in compliance with regulatory standards. You’ll investigate and evaluate claims, verify coverage, and support timely resolution while collaborating with internal teams and external stakeholders. This role involves responding to inquiries, assisting clients with proper claim submission, and maintaining detailed, compliant records. Your work helps drive operational efficiency, supports audit readiness, and ensures a seamless claims experience for all parties involved.
Key Responsibilities
Review and evaluate insurance claims to ensure accuracy and timely processing- Investigate claims, gather relevant information, and support settlement negotiations
- Respond to inquiries from claimants, providers, and other related parties
- Assist clients in submitting claims accurately and in accordance with guidelines
- Collaborate with internal teams to facilitate efficient claim resolution
- Maintain detailed, accurate records and ensure compliance with regulatory and audit requirements
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 accurate records and ensure compliance with regulatory requirements
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