Claims Support Specialist

Imagine360

6d • Remote

About The Position

Imagine360 is currently seeking a Claims Support Specialist to join our team. This individual will serve as the primary point of contact for internal staff inquiries regarding claims. The position performs research to accurately respond to inquiries from both internal customers. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility.
Position Location: 100% Remote

Requirements

• High school diploma or equivalent
• Minimum of one year of related experience.
• Work in a fast-paced environment.

Nice To Haves

• Experience in health insurance claims administration or related field.
• Working knowledge of computers and software including but not limited to Microsoft Office products.
• Demonstrated organizational, problem solving, and analytical skills as well as detail oriented.
• Strong written, telephonic, and oral communication skills
• Demonstrated ability to work independently, prioritize workloads, multi-task and manage priorities to meet deadlines.

Responsibilities

• Research claim status, payment details, denials, and adjudication issues to provide accurate and timely responses.
• Interpret plan documents, benefits, coordination of benefits (COB), and processing guidelines to resolve inquiries.
• Collaborate with Claims, Eligibility, Provider Maintenance, Customer Service, and other departments to gather information and resolve issues.
• Document all inquiries, responses, and outcomes in the appropriate tracking system for reference and reporting.
• Identify recurring issues or trends and escalate to management for process improvement opportunities.
• Participate in team meetings and provide feedback to enhance claims inquiry handling processes.

Benefits

• Multiple Health Plan Options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED