Claims Service Specialist

Job Summary

A company is looking for a Claims Service Specialist (Remote).

Key Responsibilities

• Handle customer and agent inquiries, issues, and complaints while processing health and accident claims daily
• Review claims documents and apply knowledge of medical terminology to approve or deny benefits
• Document all interactions and ensure customer satisfaction while meeting quality assurance and productivity standards

Required Qualifications

• 2-5 years of claims processing or insurance experience in a similar role
• Knowledge of medical terminology and proficiency in Microsoft Office Suite
• Ability to maintain confidentiality and deliver excellent customer service
• Capability to process high-volume claims with 95% or higher accuracy
• Strong organizational and analytical skills with the ability to work independently and collaboratively