Claims Adjuster I

Our client, a Health Insurance company, is looking for a Claims Adjuster I for their Remote location. Responsibilities:

+ Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines.

+ Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records.

+ 60% Proactively investigate and perform adjustments of claims.

+ Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.

+ 20% Updates claims audit records by entering, verifying, and securing data.

+ 10% Settle standard/complex claims through payment or denial.

+ 5% Provides claims audit information and reports by collecting, analyzing,...