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Claims Specialist
4 weeks ago
- Acknowledge receipt of claim requests.
- Upload claim documents to the case in the health claims system.
- Validate claim details in the health claims system.
- Update claim status and notes in the health claims system.
- Update TPA file for endorsement to Claims Control Team.
- Adhere to service standards of processing administrative requests.
- Ensure complete claim file documentation and submission.
- Send out letters requesting information for claim files.
- Make follow-up telephone calls, such as requesting medical information from physicians, scheduling health screenings with providers, and following up on provider payments and outstanding bills.
- Ensure complete and accurate claim file documentation.
- Maintain an understanding of different client relationships and products.
- Assist with mail sorting and distribution.
- Attend to other duties and responsibilities as needed.
- College graduate of any 4-year medical course.
- Preferably with a health claims processing background.
- Ability to initiate and prioritize work duties and small projects, multitask, be detail-oriented, organized, and possess good time management skills.
- Ability to work independently and as part of a team.
- Good computer skills, including basic proficiency in Excel, Word, and Outlook.
- Ability to use office equipment such as photocopiers and printers.
- Good knowledge of medical claims processing.
- Accurate data entry skills with a keyboarding speed of 40-45 WPM.
AXA SA is a French multinational insurance firm.
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