Claims Specialist


Garden City, NY

Industry: Insurance


Less than 5 years

Posted 260 days ago

  by    Rahul Kumar

This job is no longer available.

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.


?       Property and casualty claims review?

?       Must have 1-2years of experience

?       6monthsexperience with Claims license

?       Candidate with Bachelors degree are preferred