Claims Coordinator

Acrisure•Las Vegas, NV

1d•Onsite

About The Position

The Claims Coordinator supports the Claims team by ensuring accurate, timely processing and resolution of medical claims. This role serves as a key point of contact for providers and members, delivering responsive service while maintaining compliance and data integrity. The coordinator contributes to efficient claims operations and works to improve the overall provider and member experience.

Requirements

1+ years of experience in an administrative, customer service, claims support, or related office environment.
Strong customer service skills with the ability to communicate professionally and effectively with clients, customers, and internal teams.
Excellent attention to detail and accuracy when reviewing, processing, and maintaining records and documentation.
Analytical and problem-solving skills with the ability to research information, identify discrepancies, and resolve issues.
Proficiency in Microsoft Office applications, including Outlook, Word, and Excel.
Strong organizational and time management skills with the ability to prioritize multiple tasks and meet deadlines.
Ability to maintain confidentiality and handle sensitive information with professionalism.
Effective written and verbal communication skills.
Ability to work independently as well as collaboratively within a team environment.
High school diploma or equivalent required

Nice To Haves

additional education or related training is a plus

Responsibilities

Respond to incoming provider and member inquiries related to claims via phone and email
Review, research, and resolve claim issues in a timely and professional manner
Assist with repricing claims in accordance with plan guidelines and pricing methodologies
Verify claim status, review plan specifications, and generate Explanation of Benefits (EOBs)
Maintain and manage the Claims inbox to ensure timely follow up and resolution of requests
Document all interactions, including inquiries, complaints, and actions taken, in the system
Ensure all activities comply with HIPAA and company data privacy standards
Monitor and maintain daily claims related productivity expectations
Support provider and member needs by proactively identifying solutions and improving outcomes
File and organize electronic and paper documentation as required
Provide general administrative and office support to the Claims team as needed