Claims Specialist
Company: VirtualVocations
Location: Mission Viejo
Posted on: April 1, 2025
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Job Description:
A company is looking for a Claims Specialist to resolve complex
claims and advocate for members navigating their healthcare
benefits.
Key Responsibilities
Resolve complex claims issues by investigating discrepancies and
coordinating resolutions
Coordinate benefits across various carriers, including Medicaid and
Medicare
Educate members on their benefit plans and guide them through
claims scenarios
Required Qualifications, Training, and Education
At least 2 years of experience in healthcare, customer service, or
claims
Familiarity with plan documents, ACA guidelines, Medicare, and
COBRA
Proficient in MS Word and Excel, with experience using internal
databases
Ability to analyze claims and propose practical solutions
Strong listening skills to guide members through complex
situations
Keywords: VirtualVocations, Mission Viejo , Claims Specialist, Other , Mission Viejo, California
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