Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
9 - 12 Years Healthcare experience must
9 - 12 years of experience in US Healthcare Payor operation.
Including, 7-10 years of experience in managing teams,
Strong operational & people management skill with experience of handling minimum of 100 employees
Working & Team handling Experience in claim adjudication/ Payment integrity/Enrollment
Excellent communication & interpersonal skills; team oriented and strong consensus building
Advanced knowledge of MS Word, MS Excel and Data management
Ability to operate in a rapidly changing environment with a sense of urgency, and to develop and deploy changes positively
Demonstrated analysis and problem solving abilities
Strong organizational and time management skills
The ability to multitask and self-manage workday is crucial.
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