Claims Specialist

To support a mission of simplifying healthcare, the full-time remote Claims Specialist will resolve complex claims issues, coordinate benefits across various carriers, and educate members on their benefit plans. Key responsibilities Investigate billing discrepancies and coordinate resolutions among members, carriers, and providers Manage cases involving Medicaid, Medicare, and other benefit programs to ensure proper coordination Guide members through their benefit plans and assist them in navigating challenging claims scenarios Required qualifications At least 2 years of experience in healthcare, customer service, or claims Familiarity with plan documents, ACA guidelines, Medicare, and COBRA Proficiency in MS Word and Excel, with comfort in using internal databases Strong analytical skills for identifying root causes of claims issues Ability to maintain a private, HIPAA-compliant workspace for handling sensitive information