Claims Processor
job description

Claims Processor

Are you a detail-oriented professional with a passion for ensuring accurate and timely processing of insurance claims? If so, we have an exciting opportunity for you to join our team as a Claims Processor.

As a Claims Processor, you will play a crucial role in our organization, responsible for reviewing, analyzing, and processing a variety of insurance claims. Your primary duties will include:

- Carefully reviewing and verifying the accuracy of claim information, including supporting documentation
- Determining coverage eligibility and calculating appropriate claim amounts in accordance with policy terms
- Communicating with policyholders, healthcare providers, and other stakeholders to gather additional information or clarify discrepancies
- Maintaining detailed records and documentation throughout the claims process
- Identifying and escalating any potential fraud or abuse cases
- Adhering to all relevant policies, procedures, and regulatory requirements

To be successful in this role, you should possess the following qualifications:

- High school diploma or equivalent, with some post-secondary education or training in insurance, finance, or a related field preferred
- 1-3 years of experience in a claims processing or customer service role, preferably in the insurance industry
- Strong attention to