Senior Claims Specialist, Financial Lines
MSIG USA
Claim Benefit Specialist
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $17 - $28 per hour
Job Level
Mid-LevelSenior
About the role
- Reviews and adjudicates claims in accordance with claim processing guidelines.
- Claim Benefit Specialists have the opportunity to enhance and improve member satisfaction and retention by providing accurate and timely resolution in processing medical claims.
- You will be a key link in providing our customers with prompt, efficient, high quality claim service.
- Determine and understand the coverage provided under a member's health plan.
- Efficiently use multiple systems and screens to obtain and record claim information.
- Review claims information to determine the nature of a member's illness or injury.
- Identify claim cost management opportunities and refer claims for follow up.
- Make claim payment decisions.
- Process claims accurately to enhance customer satisfaction and retention.
- Process claims within quality and production standards.
- Assist team members in support of achieving team, office, regional, and national goals.
Requirements
- Experience in a quality and production environment.
- Attention to detail.
- Ability to use multiple computer applications at one time.
- Claim processing experience.
- Attendance during the 21 week training period is required.
- Prior medical claim processing experience is a plus.
- Exceptional analytical skills.
- Accurate and fast keyboarding skills.
- Knowledge and experience in Windows environment.
- Effective verbal and written communication skills.
- Ability to adapt quickly and willingly to change.
- Positive, willing attitude.
