Claims Specialist
Job Summary
TerraBarn Inc. is seeking a Claims Specialist to identify and implement new claims procedures, evaluate and resolve claims, and analyze medical claims to ensure accurate payments. The ideal candidate will possess strong attention to detail, analytical skills, and experience in claims processing or healthcare. This role requires maintaining strict confidentiality of patient medical records and coordinating healthcare coverage eligibility.
Responsibilities
- Identify and implement new claims procedures
- Evaluate and resolve claims based on company standards
- Analyze medical claims for accurate payments
- Verify documents and coordinate coverage eligibility
- Review medical records
- Process claims from accredited clinics and hospitals
- Ensure accurate transmittal of checks
- Maintain strict confidentiality of patient records
Required Skills
- Strong attention to detail and analytical skills
- Experience in claims processing, healthcare, or insurance
- Ability to handle sensitive and confidential information
- Good communication and problem-solving skills
- Familiarity with medical terms and documentation
Job Details
Identify and implement new claims procedures
Evaluate and resolve claims based on company standards
Analyze medical claims to ensure accurate payments
Verify documents and coordinate healthcare coverage eligibility
Review medical records for pre-existing conditions and coverage factors
Process claims from accredited clinics and hospitals nationwide
Ensure accurate transmittal of checks to clients
Maintain strict confidentiality of patient medical records
Qualifications:
Strong attention to detail and analytical skills
Experience in claims processing, healthcare, or insurance (preferred)
Ability to handle sensitive and confidential information
Good communication and problem-solving skills
Familiarity with medical terms and documentation is an advantage