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Medical Claims Specialist

9/29/2025

Remote

Job Summary

A company is looking for a Medical Claims Specialist - Remote WV.

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

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