
Claims Resolution Specialist
6 days ago
Job Title: Claims Resolution Specialist
We are seeking a highly skilled and detail-oriented Claims Resolution Specialist to join our team. The ideal candidate will have a strong background in claims processing and be able to effectively review and resolve claims in a timely manner.
Key Responsibilities:
- Claims Review and Processing
- Conduct thorough reviews of claim forms to ensure all necessary documents are submitted and complete.
- Resolve claims according to company guidelines and industry regulations.
- Verify the accuracy of claim information and check against policy details to ensure eligibility.
- Customer Interaction
- Communicate with claimants to request additional information or clarify details.
- Respond to customer inquiries regarding the status of their claims, providing updates as needed.
- Resolve customer issues and concerns by offering timely solutions and support.
- Claims Analysis and Reporting
- Review claims for compliance with company policies, identifying potential fraud or discrepancies.
- Assist in preparing claims reports according to client's requirements.
- Continuous Improvement
- Suggest process improvements to enhance the efficiency and accuracy of the claims processing system.
Requirements:
- Bachelor's degree in Accounting or related field.
- 1-3 years of experience in claims processing or a related field.
- Familiarity with claims management software and office productivity tools.
- Strong attention to detail and accuracy in operational activities.
- Excellent verbal and written communication skills.
- Ability to multitask and prioritize in a fast-paced environment.
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