Claims Specialist

• Collecting information through handling incoming calls, ensuring timely and courteous verification. 
• Inform clients about processes, procedures, and expectations in a clear and helpful manner. 
• Coordinate the necessary documentation for claims processing, utilizing both internal systems and external resources.
• Generate letters and update claim systems for newly reported claims. 
• Address and follow up on outstanding requirements for pending claims, resolving them efficiently. 
• Investigate and gather essential data from various sources such as beneficiaries, physician records, medical facilities, legal documents, etc., to facilitate effective claims processing.
• Record detailed notes related to interactions with policy-related personnel.

• Effective communication skills, both written and verbal. 
•   Proficiency in handling multi-line phone systems, with the ability to route and escalate calls as required.
• Exceptional interpersonal skills, fostering positive relationships. 
• • Strong organizational and time management capabilities. 
• • Patient and empathetic demeanor. 
• • Active listening skills.
•   • Adaptability and flexibility in dynamic work environments. 
• • Comfortable working within fast-paced settings.
•   • Troubleshooting skills, varying from basic to advanced based on role and industry. 
• • Proficient computer skills, including data entry proficiency. 
• • Adherence to all applicable laws, regulations, and contractual obligations while conducting company business with ethics and integrity, aligning with the Compliance Program principles.