Claims Specialist

Claims Specialist needs 1 year claims system experience, preferably in the Healthcare industry

• College degree or equivalent experience required
• Minimum of 1 year claims system experience, preferably in the Healthcare industry
• Basic analytical and problem solving skills
• Good communication and interpersonal skills
• Ability to work independently and with others
• Ability to manage more than one assigned tasks at the same time

• Responsible for setting up new Managed Care groups in the claims system
• Responsible for fulfilling requested revisions to existing Managed Care group in the claims system (except Reseller product changes)
• Responsible for creating standard products in the system (using the Product Key Sheet method)
• Responsible for performing audits on client setup or maintenance requests (excludes complex product configuration requests)
• Follow the established corporate and industry audit controls (i.e. SOX, SSAE 18, etc.) when fulfilling setup and maintenance requests
• Resolve client structure setup questions/issues sent to the team with minimal supervisor guidance
• Maintain relationships with Implementation Managers and Account Managers to facilitate fulfillment of implementation questions and requests in a timely manner