Claim Specialist

• Provides production support to multiple groups within Operations Services or enterprise wide
• Executes a variety of routine tasks within multiple operational systems
• Interacts with multiple internal partners
• Duties may include functions related to payment transactions or claim processing, data entry, archiving, researching, troubleshooting and vendor/client interaction
• May have direct contact with 3rd party vendors and / or external customers
• Researches exceptions and escalates issues to management as appropriate
• May have the opportunity to recommend and implement developed processing improvements within production

• High school diploma or equivalent
• Four to five years or more of operations services related work experience
• Knowledge of products, services, terminology, procedures and systems related to assigned area, as well as applicable laws and regulatory requirements
• Proven commitment to high quality customer service
• Ability to work well with external and internal customers
• Good time management skills to maximize production and execution of tasks in a fast-paced environment
• Good understanding and knowledge of internal policies and procedures within Operations Services and enterprise wide
• Physical requirements could include lifting trays of work, pushing carts of work, standing or sitting for extended periods of time, and repetitive motions
• Ability to identify, analyze and resolve exceptions through data interpretation
• Strong PC skills
• Good verbal and written communication skills

Demonstrates expertise in operations services with a strong focus on customer service, data interpretation, and process improvement. Capable of managing multiple tasks efficiently in a fast-paced environment while ensuring compliance with internal policies and procedures.