Senior Claims Benefit Specialist

Job Summary

A company is looking for a Senior Claims Benefit Specialist - Remote.

Key Responsibilities

• Review and adjudicate complex claims in accordance with processing guidelines
• Handle customer service inquiries related to pre-approval, reconsiderations, or appeals
• Train and mentor junior claim benefit specialists while ensuring compliance with company practices

Required Qualifications

• 2+ years of medical claim processing experience
• 1-2 years of experience in a production/metrics-based environment
• Demonstrated ability to manage multiple assignments effectively
• High School Diploma required
• Preferred Associate's degree or equivalent work experience