Claims Specialist III

Job Summary

A company is looking for a Claims Specialist III (Facets Claims).

Key Responsibilities

• Resolve complex COB issues and adjust claims accurately and timely
• Identify and implement process improvements in collaboration with peers
• Act as a technical resource for training and assist providers with inquiries

Required Qualifications, Training, and Education

• High School Diploma or equivalent is required
• Minimum of one (1) year of experience in a claims environment or related healthcare operations
• Previous experience in an HMO or related industry preferred
• Facets claims processing experience strongly preferred
• Previous Medicare/Medicaid dual eligible claims experience is preferred