battleface

Claims Specialist

• Investigate, evaluate, and resolve travel medical claims end-to-end
• Adjudicate benefits per policy terms and statutory requirements
• Process invoices through cost-containment networks
• Maintain clear, timely updates to customers, providers, and partners on claim status
• Document thoroughly in the claims system and ensure complete, high-quality files
• Assess the need for medical management and escalate appropriately
• Process bills in accordance with statutory requirements and internal controls
• Identify potential fraud/waste/abuse and collaborate with investigative team
• Deliver excellent written and verbal customer communication throughout the claim lifecycle
• Perform additional responsibilities as needed to support the team and our customers

Claims Adjuster