Insurance Claims Specialist | Patient Financial Services
St Augustine, FL
Full-time
Onsite
2 months ago
About the role
Overview
Work alongside an engaged onsite team focused on claims resolution, compliance, and customer service excellence.
š» Work Style: Onsite
š Location: St Agustine, FL
š FTE: Full-Time (1.0 FTE)
ā° Schedule: Monday ā Friday, 8:00 AM ā 4:30 PM
Manages and evaluates insurance claims to ensure accurate coverage determination and timely processing. Investigates claims, reviews supporting documentation, and responds to inquiries from claimants, providers, and payers.
Assists clients in submitting claims accurately and coordinates with internal teams to facilitate efficient resolution. Maintains detailed records, verifies claim compliance, and supports audit and regulatory requirements. Collaborates with stakeholders to resolve discrepancies and improve overall claims processing efficiency.
Responsibilities
Key Responsibilities
Qualifications
Minimum Qualifications
Work alongside an engaged onsite team focused on claims resolution, compliance, and customer service excellence.
š» Work Style: Onsite
š Location: St Agustine, FL
š FTE: Full-Time (1.0 FTE)
ā° Schedule: Monday ā Friday, 8:00 AM ā 4:30 PM
Manages and evaluates insurance claims to ensure accurate coverage determination and timely processing. Investigates claims, reviews supporting documentation, and responds to inquiries from claimants, providers, and payers.
Assists clients in submitting claims accurately and coordinates with internal teams to facilitate efficient resolution. Maintains detailed records, verifies claim compliance, and supports audit and regulatory requirements. Collaborates with stakeholders to resolve discrepancies and improve overall claims processing efficiency.
Responsibilities
Key Responsibilities
- Review and evaluate insurance claims to ensure accuracy and timely processing
- Investigate claims, gather relevant information, and support settlement negotiations
- Respond to inquiries from claimants, providers, and other related parties
- Assist clients in submitting claims accurately and in accordance with guidelines
- Collaborate with internal teams to facilitate efficient claim resolution
- Maintain detailed, accurate records and ensure compliance with regulatory and audit requirements
Qualifications
Minimum Qualifications
- High school diploma or equivalent required
- 2+ years of experience in insurance claims processing or related support
- Working knowledge of insurance policies, coverage, and claim adjudication processes
- Experience investigating, resolving, and following up on claim issues
- Strong communication and customer service skills
- Ability to maintain accurate records and ensure compliance with regulatory requirements
Skills
OtherHospitals and Health Care