Claims Specialist

Confidential Company  •  Garden City, NY

Less than 5 years experience  •  Insurance

Salary depends on experience
Posted on 03/03/18 by Rahul Kumar
Confidential Company
Garden City, NY
Less than 5 years experience
Insurance
Salary depends on experience
Posted on 03/03/18 Rahul Kumar

Analyze routine insurance claims to determine the extent of the insurance carrier's liability and to settle claims in accordance with the plan provisions.

Essential Duties

 

  • The Claims Specialist sets adequate reserves to ensure proper reporting.
  • Compares data on claim form with insurance plan to ascertain completeness and validity of claim.
  • Examines claim form and other records to determine insurance coverage.
  • Proactively works to resolve claim as expeditiously as possible.
  • Reviews and analyze detailed medical records.
  • Calculates reimbursement of benefits according to the schedule of coverage.
  • Runs various claim reports as directed by the account.
  • Approves claims at the appropriately demonstrated assigned authority level.
  • Handles difficult phone calls.
  • Composes special correspondence.
  • Works on special projects and tasks as assigned. Other duties as assigned.

Required

?       Property and casualty claims review?

?       Must have 1-2years of experience

?       6monthsexperience with Claims license

?       Candidate with Bachelors degree are preferred

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