Claims Specialist II

Employer Industry: Health Insurance

• Opportunity for career advancement and growth within the organization
• Supportive and collaborative work environment
• Engaged in meaningful work that improves the health and lives of Louisianians
• Comprehensive training programs to enhance your skills
• Work in a smoke and tobacco-free environment promoting good health

• Process claims edits, determine primacy for Coordination of Benefits (COB), and adjust previously paid claims
• Analyze, investigate, and resolve problem cases while executing recovery processes
• Communicate with internal and external contacts to provide necessary and accurate information for claims
• Review quality audits and ensure accuracy of claims processing within corporate guidelines
• Execute procedures to recover funds from providers and beneficiaries for over payments

• High School Diploma or equivalent required
• Minimum of 2 years of experience in medical claims processing
• Strong analytical abilities and logical thinking skills
• Excellent oral and written communication skills
• Proficiency in relevant PC software

• Experience with Coordination of Benefits (COB) processing
• Strong human relations skills

#Health Insurance #Claims Processing #Career Growth #Supportive Work Environment  #Louisiana Jobs

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