Claims Specialist

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Precise processing of claims adjustments

• Identifying the primary coverage for Coordination of Benefits (COB)

• Modifying previously settled claims

• Initiating actions to recover funds on claims that were overpaid

• Adhering to all laws and regulations pertinent to the responsibilities

• Evaluating, researching, and making necessary modifications to claims

• Engaging with internal and external stakeholders to maintain accurate claim records

• Investigating and determining the correct order of benefits for payment

⛳️ Requirements

• High School Diploma or equivalent is required

• Minimum of 6 months of experience in medical claims or customer service in health insurance

• Successful completion of BCBSLA adjustment or COB training

• Strong analytical skills

• Proficient oral and written communication skills

• Effective human relations skills

• Familiarity with relevant PC software

• Certification in Medical Billing or Coding may substitute for experience

🏝️ Benefits

• Access to resources for a healthy lifestyle

• Opportunities for personal health improvement

• Continuous learning options

• Skill development support

• Professional growth opportunities

• Commitment to serving local communities