Claims Specialist I
Arkansas Blue Cross and Blue Shield · Remote (Arkansas)
- Resolve medical claims that do not adjudicate automatically, accurately and on time.
- Enter claim data and interpret contract benefits.
- Conduct edit and audit resolution and confirm benefit eligibility.
- Identify and research processing issues using systems and manuals.
- Route claims to other areas and consult internal staff and medical providers.
- Generate correspondence and complete forms to obtain missing information.
- Keep current through training and continuing education on claims knowledge.
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