Claims Specialist

hace 2 semanas


Santiago de Querétaro, Querétaro de Arteaga, México Scalepex A tiempo completo

Claims Specialist

We are seeking a meticulous Claims Specialist to uphold our high standards of quality and procedure adherence, ensuring seamless claim processing in accordance with company policies. Your responsibilities will include thorough claim reviews, timely completion of tasks to meet production targets, and meticulous attention to detail in system setup and documentation comprehension. You'll also be tasked with identifying and promptly reporting any discrepancies or issues to management, contributing to the continuous improvement of our processes.

Key Responsibilities:

  • Thoroughly review claims to ensure accuracy and compliance with company policies.
  • Complete tasks in a timely manner to meet production targets.
  • Maintain attention to detail in system setup and documentation comprehension.
  • Identify and report discrepancies or issues to management.

Requirements:

  • High School Diploma required; Associate Degree in Business preferred.
  • Minimum of 2 years' experience in claims processing.
  • Experience in QicLink or Eldorado system preferred or large claims platform.
  • Proven ability to establish and maintain positive client relationships and deliver exceptional customer service.
  • Proficiency in Windows and Microsoft Office Suite, particularly Word, Outlook, and Excel.
  • Familiarity with insurance database systems is advantageous.
  • Strong teamwork and collaboration skills.
  • Preferred experience in the healthcare industry, specifically in healthcare administration, health insurance, or medical office settings.
  • Remote work may be considered based on experience and business requirements.

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