Insurance Claim Specialist

Sr Technical Recruiter at Mastech Digital

Responsibilities

• Review and adjudicate insurance claims (Accident, Critical Illness, Hospital Indemnity, Life, Weekly Income).
• Verify eligibility using claim forms, medical records, policy documents, and regulations.
• Calculate benefit payments accurately
  .
• Request missing information from doctors, members, employers, or agencies.
• Approve, pay, or deny claims in compliance with regulations.
• Provide customer service via phone and written communication.
• Maintain accurate documentation in claim systems.
• Follow HIPAA, confidentiality, and unfair claims practices laws
  .
• Meet productivity, quality, and turnaround-time standards.

Required Skills & Background

• Bachelor’s degree or 4 years of related business/claims experience.
• Experience with claims processing or insurance operations
  .
• Strong attention to detail and analytical skills
  .
• Good customer service and communication skills
  .
• Knowledge of medical terminology
  .
• Comfortable using MS Word, Excel, Outlook, Share Point .
• Ability to work in a fast-paced, rules-driven environment
  .

Preferred / Nice to Have

• Experience with Supplemental Health, Life, or Disability claims
  .
• Knowledge of ERISA and state insurance regulations
  .
• Familiarity with claim systems (ECM, STAR, Salesforce, Genelco, UTS, Benefits Manager).
• Insurance certifications (HIAA, LOMA, ICA).

• Entry level

• Contract

• Other and Engineering

• Hospitals and Health Care
• Retail Health and Personal Care Products
• Public Health

Referrals increase your chances of interviewing at Mastech Digital by 2x

Apply BELOW