Claims Processor Job Description

claims processor job description includes a detailed overview of the key requirements, duties, responsibilities, and skills for this role.

Last update : July 14, 2023

Claims Processor Job Description

Claims processors are people who facilitate insurance claims.

Claims processors are people who facilitate insurance claims.

They can contact the insurer when necessary.

Checking and verifying information, sending documents to insurance companies, and responding to phone calls are some of the tasks performed by claims processors.

Claims processors may also communicate with claimants.

The communication may be done by phone, email, or fax, and may involve processing paper or electronic claims.

Claims processors may assist customers with their claim.

This may include making recommendations regarding the claim, writing letters, or handling claims for payment.

Job Brief:

We’re looking for a Claims Processor who is detail-oriented and able to work independently. The Claims Processor will be responsible for reviewing and processing insurance claims in a timely and accurate manner.

Claims Processor Duties:

  • Develop and maintain claim forms and processes
  • Create billing and accounting reports
  • Maintain records of business activity
  • Research and prepare claims
  • Maintain databases, and other company records
  • Develop new claim forms and processes
  • Perform data input
  • Assist with special projects

Claims Processor Responsibilities:

  • Handle high-volume claim processing, including document review, data entry, and investigation
  • Research, analyze, and resolve claims and process payments in accordance with Medicare/Medicaid regulations
  • Provide superior customer service to internal and external customers via phone, email, and in-person encounters
  • Research and validate benefits, address discrepancies, and resolve customer complaints
  • Perform ongoing audit and investigative functions
  • Stay current with changes in the industry through coursework, training, and conferences
  • Develop and maintain workflow processes to optimize productivity and reduce costs

Requirements And Skills:

  • Bachelor’s degree
  • 2+ years of experience in claims processing
  • Strong organizational and communication skills
  • Quick learner
  • Ability to handle multiple tasks in a fast-paced environment
  • Demonstrated ability to work under minimum supervision

At [Company Name], we’re proud to be an Equal Opportunity Employer. We’re committed to building a diverse and inclusive team, and we encourage applications from people of all races, religions, national origins, genders, , and ages.

Share this article :