Claims Processor

Job Summary: 

We are seeking a detail-oriented and organized Claim Processor Specialist to reviews, verifies, and processes insurance claims to determine coverage eligibility, ensuring compliance with company and regulatory guidelines. You will act as the primary liaison between policyholders, insurance agents, and providers to gather information, calculate payments, and manage documentation to ensure prompt resolution.

Responsibilities:

• Review and process insurance claims accurately and promptly.
• Verify and analyze documentation to ensure completeness and eligibility under policy terms.
• Communicate with claimants, agents, and other stakeholders virtually to request additional information or clarify details.
• Evaluate claim validity and recommend approval, denial, or escalation.
• Maintain detailed electronic records of claim processing activities and decisions.
• Identify and...