Claims specialist requirements

Claims specialist requirements

In addition, you resolve discrepancies, clarify issues, and make final decisions for initial and post-entitlement benefits and payments; adjudicate entitlement…. 40 to 60 hours per week. Start becoming familiar with the insurance licensing requirements for the states you expect to work claims in. Denver, CO. gov…. S-260, Interagency Incident Business Management. Their responsibilities include Verifying the details of a claim. Gather incident details and medical information to evaluate the potential claim. Full-time. Position Overview The Workers Compensation Claims Specialist is responsible for the being the liaison between the Aveanna Field Staff and the third party…. Investigating insurance claims through interviews and assessments. Popular majors include business, criminal justice, health care administration, psychology, and accounting. A working supervisor position which assigns work for a small group of disability claims specialists and clerical personnel; including performance evaluation, guidance and control, in addition to performing claims adjudication. Outside issues such as peak filing season, systems down time, inclement weather, holidays, and absenteeism may directly affect the volume of work for each Specialist Requirements Education & Experience: 1. Senior Claims Specialist job description example 1. Personal Injury law firm looking to hire a legal assistant/records specialist,…. 00 per hour, and the lower 10% made around $18. The large variance in wages can be attributed to the variety in duties and responsibilities as well as years of experience in the Feb 20, 2024 · Social Security Claims Specialist Job Requirements. 76% of specialists holding this level of education. Allstate. 4 year Bachelors Degree (Preferred). Most questions present a coding scenario to test proper application of CPT ® procedure codes, HCPCS Level II supply codes, and ICD-10-CM diagnosis codes. Apr 25, 2024 · The educational requirements for a claims service specialist typically include a high school diploma, with 54. Claims representatives serve as the liaison between a policyholder and an insurance specialist and are often the initial point person for insurance-related events. However, salaries can vary depending on factors such as location, level of experience, and industry. , High School Diploma, College Transcript, DD-214, etc. Purpose and Scope of Work: Disability Claims Specialist IV positions are typically of three general types: A. Apr 17, 2024 · Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. View qualifications, responsibilities, compensation details and more! Apr 22, 2024 · The average salary for a Claim Specialist is $73,756 per year in United States. Learn more about the Claims Specialist position available at Social Security Administration. Get the right Professional liability claims specialist job with company ratings & salaries. Apply to Human Resources Specialist, Information Specialist, Loan Specialist and more! Property Claims Specialist. Claims Specialist. Bodily injury and property damage liability claims, as well as uninsured or underinsured motorist coverage claims HOURS OF OPERATION: The anticipated hours of operation will be 8 a. Therefore, any discriminatory action taken on account of an employee's ancestry, age, color, disability, genetic information, gender, gender identity, gender expression, sexual and reproductive health decision, marital status, medical condition, military or veteran status, national origin, race (include Claims service specialists assist customers in filing insurance claims, frequently serving as the initial and main point of contact with the customer. Career Paths. Apr 22, 2024 · The estimated total pay for a Claims Management Specialist is $78,221 per year in the United States area, with an average salary of $66,839 per year. Note: Once qualified as a COMP, the CLMS qualification may be granted by the certifying official. At State Farm we invest in our employees by providing a competitive Total Rewards package: Starting Salary is $55,029. This free Claims Specialist job description sample template was created in part with the OpenAI API and thoroughly edited and fact-checked by our editorial team. Maintains a good relationship with insurance departments. 50 per hour commensurate with experience along with benefits that include: Medical (pays 75% of selected coverage), Dental, 401(k) with match, Life, STD, LTD, 5 weeks PTO, and 10 paid Holidays. Because work-life-balance is a priority at State Farm, compensation is based on our standard 38:45-hour work week! Salary offered is dependent on skills and qualifications, with Mar 31, 2023 · Certified Billing and Coding Specialist (CBCS) Cost: The cost of the Certified Billing and Coding Specialist exam is $125. A claims specialist plays a key role in the automobile, home, health, and business insurance industry. Certification must be documented. 03% have an associate degree. 63 annually, ($39. 31/hr) - $79,230. Coordinate with in-house risk management team on detailed incident investigation and gathering all necessary elements to successfully resolve a claim. This role is designed for AAPC certified professionals with prior experience working as an employee in a medical billing agency role. The average Claims Specialist salary in California is $60,190 as of November 27, 2023, but the salary range typically falls between $54,678 and $67,067. Protects operations by keeping claims information confidential. Bodily injury and property damage liability claims, as well as uninsured or underinsured motorist coverage claims. Excellent knowledge of insurance claims process. Mar 14, 2024 · This Medical Claims Specialist position provides an hourly range of $14. Apr 5, 2024 · The educational requirements for a claim specialist are typically a bachelor's degree. Jun 30, 2023 · 3. Full-time + 1. Active 3 days ago. About us Social Security provides financial protection for our nation’s people, supporting Americans throughout all of life’s journeys. Claims Specialist positions are located in each of our 107 field offices and at our processing center in Jamaica, New York. The Workers Compensation Specialist plays an integral role within organizations, focusing on managing claims and ensuring that both the employer and employees navigate the complexities of workers’ compensation processes efficiently. Experience in a claims environment handling lost time claims including litigated files. claims. Oct 26, 2022 · Claim Specialist Job Requirements A Claim Specialist is responsible for investigating and processing insurance claims. Prepare reports and statements by gathering and summarizing information. Examining insurance claims to uncover evidence of fraud. Plays a vital role delivering Social Security benefits and services to the public. m What is a Claims Specialist? Claims specialists provide administrative and customer relations support related to the processing of insurance claims. Detail-oriented and organized approach to work. Sep 7, 2022 · Claims Specialist Duties & Responsibilities: Review insurance policies, medical records, and other documentation to establish coverage for claims. Feb 13, 2024 · The regular duties performed by insurance claim specialists include: Communicating with clients (the insured), insurers, service providers or other parties. 21% of claim specialists hold a bachelor's degree. Dec 27, 2018 · General Duties. This position involves a thorough understanding of legal requirements, company policies Oct 1, 2023 · Claims denial is a common occurrence in the insurance industry and it’s important for a Medical Claims Specialist to navigate these situations effectively. Some claim specialists also hold certifications such as Certified Billing Las Vegas, NV 89101. King's Insurance Staffing LLC. Check your state's requirements, prepare the paperwork and enroll in an online course to prepare for any necessary exams. According to the data, 54. Identifying and evaluating coverage issues, preparing coverage letters and analysis, retaining and managing coverage counsel through trial, and Effectively settle claims and gain on-the-job skills specific to your specialty with the Associate in Claims (AIC) designation. This question is designed to evaluate your problem-solving skills, your understanding of the appeals process, and your ability to communicate with both healthcare providers and patients. Determine liability and total value for general Disability Claims Specialist Education and Training Requirements A Disability Claims Specialist typically needs a bachelor’s degree in fields like social work, psychology, or a related field. If you claim membership, license, certification, or credentials, you must submit a copy of said document in your application package. Apply to Customer Specialist, Customer Service Representative, Diesel Mechanic and more! Jul 12, 2023 · This article provides an overview of the best claim specialist certifications available, highlighting their key features and benefits. They also speak with beneficiaries about their rights under Social Security laws, gather facts and evidence to establish eligibility for benefits, determine benefit amounts to individuals, and use technology to access and update 5 days ago · 316 State Farm Claim Specialist jobs. Jul 14, 2023 · A claims specialist is an individual who acts on behalf of an insurance company and is responsible for investigating and settling customer claims. The entry level is GS-5 with promotion potential to the GS-7/9. In some instances, they collaborate with representatives from other insurance companies for an incident that is relevant to both industries, including medical and automotive carriers. Education: A Social Security Claims Specialist typically holds a Bachelor’s Degree, with common majors including public administration, social work, or psychology. Today ·. [Work Hours and Benefits] Mentioning the work hours and benefits should be the next part of your claims specialist job description. Paralegal Specialist, GS-950-9/11/12. Stobys senior claims specialist job description. Attention to detail and accuracy. Most relevant. Easily apply. Negotiation. Interact extensively with various parties involved in the claim process. - 6 p. ) Easy Apply. A legal intake specialist, also known as a “claims intake specialist,” gathers information from new and prospective clients for law firms. Post a Job. Remote in United States. Social Security Administration. Attorney Advisor, GS-905-9/11/12. Apr 1, 2024 · A medical claims specialist plays an important administrative role in the healthcare industry, ensuring that these medical claims are legitimate, completed accurately and eligible for reimbursement under a patient’s insurance coverage. It can help you attract an experienced Claims Specialist to your organization. Take the insurance licensing exam and pass. $76,115 - $121,586 a year. Jan 22, 2024 · Legal Administrative Specialist (LAS) This remote call center style position requires long periods of time on the phone with the public to advise and provide information on Veterans’ benefits and rights. Ability to use various computer software and applications. ssa. Jul 19, 2023 · A Freight Claims Specialist is responsible for handling claims related to damaged or lost shipments. 50 an hour. Nationwide total loss specialist job description. About the CPC exam. Monday to Friday + 1. 7,262 open jobs for Claims specialist. Apr 25, 2024 · On average, claims coordinators earn higher salaries than claims support specialists, with a $1,587 difference per year. Advises claims adjusters regarding handling of claims. If you live in a state that requires adjusters to be licensed, you should get your home state license first. Apr 24, 2024 · Federal Grade Levels & Salaries for Claims Specialist: GS-5: $44,020 (entry level salary with career ladder promotion to GS-11) GS-7: $57,007 (entry level salary with career ladder promotion to GS-11) GS-9: $69,729; GS-11: $84,366 to $109,673; Other Competitive Promotions Beyond Claims Specialist: GS-12 Claims Technical Expert Warranty Claims Adjusting Specialist - Remote. Fredericksburg, VA. $39,576 - $63,733 a year. Davies US LLC. Certified Registered Health Information Technician. These numbers represent the median, which is the midpoint of the ranges from our proprietary Total Pay Estimate model and based on salaries collected from our users. 65 ($27. 00 - $80,612. 06/2016 - PRESENT. Lead Case Technician, GS-986-9. Claims at Nationwide. Resolution may include additional investigation or communication in order to obtain necessary information to complete the claim. Using the responsibilities included on claims support specialists and claims coordinators resumes, we found that both professions have similar skill requirements, such as "data entry," "customer service," and "phone calls. rdquo; Workers’ Compensation Claims Specialist II – Lost Time Adjuster. Manages the financial responsibilities for the agency. 636 open jobs for Professional liability claims specialist. Resolve claims by approving or declining documentation. Expected hours: 25 – 30 per week. Learn how to become a Claims Specialist, what skills you need to succeed, how to advance your career and get promoted, and what levels of pay to expect at each step on your career path. Claims specialists provide administrative and customer relations support related to the processing of insurance claims. They must handle and dispose of claims in litigation, negotiate settlements, and manage an average caseload of individual disability insurance claims. 50 a year. 91 in 2014. Evaluate your skill set and professional abilities. Hybrid work in Watertown, NY 13601. Analyze and investigate insurance claims to discover or prevent fraud. Using the responsibilities included on medical claims specialists and medical biller coders resumes, we found that both professions have similar skill requirements, such as "customer service," "patients," and "medicaid. Senior Commercial Litigation Claims Specialist. Authorizing the claim--This is exercising the agency's authority to allow or disallow the claim. Workers Compensation Claims Specialist. A well-written claim specialist job posting can help attract a talented and highly qualified pool of candidates. A Under the direction of the Division Chief, Correction Claims, with latitude for independent analysis, judgment and initiative, the Claims Specialist Level III responsibilities include, but are not limited to, the following: Complete a full investigation of claims against the City, which includes obtaining and reviewing agency reports and Claims Specialist. May 2, 2024 · Follow these steps if you're interested in becoming a claims adjuster and have no professional experience in this field: 1. 178 Claims Specialist jobs available in Washington, DC on Indeed. Researching the terms and stipulations of insurance policies and Mar 14, 2024 · Claim specialist requirements can be divided into technical requirements and required soft skills. Negotiates and settles basic and occasionally moderately complex claims in accordance with business unit best practices. Supervisory Attorney or Supervisory Paralegal Specialist, GS-950-13. 2,209 Complex claims specialist jobs in United States. Title XVI Claims Specialist Basic Training Page 10 2018-2 Documenting Evidence Electronically Record any necessary evidence provided by the claimant electronically in the SSI Claim System or EVID, or fax it to the electronic eDIB folder or the Non Disability Repository Application (NDRed) as appropriate. Utilize the State Farm Claims System (SFCS) to document all claim activity. However, the top 90% of claims specialists made about $44. Job Brief. Proficient with electronic health records computer software. - 7 p. 1. Research, resolve, and prepare claims. They play an active role in all phases of the claims process, from the initial intake through the final payout. ( Cultural Corridor area) $16. 32/hr). 03% having this qualification. We have included claim specialist job description templates that you can modify and use. This authority may rest in the same employee who initially adjudicates the claim or may be assigned to employees in other types of positions. $21 - $28 an hour. According to the data, 69. Recommended Claims Specialist Resume Keywords & Skills based on most important Skills Found on Successful Claims Specialist resumes and top skills required by employers. Work in a dynamic environment where no days are the same. Under the direction of the Division Chief, Affirmative Claims, with wide latitude for independent initiative and judgment, the duties and responsibilities for the Claims Specialist, Level III, Affirmative Claims position include, but are not limited to, the following: Identify and investigate reports of damage to City vehicles/property caused S-261, Applied Interagency Incident Business Management. com. 2. Hearing Office Director, GS-950-14. Provides consultative support and technical direction to the field on large losses relating to investigative strategy, confirmation of coverage, determination of liability, scope of damages, reserves, pursuit of recovery interests, and litigation management. You also resolve discrepancies and make final decisions for initial and post-entitlement benefits and payments Claim handling experience, preferably PIP/MPC (first party medical) or third party injury claims. As such, depending on the customer Claims representatives serve as the liaison between a policyholder and an insurance specialist and are often the initial point person for insurance-related events. $100K - $120K (Employer est. Apply to Senior Claims Specialist, Financial Specialist, Claims Coordinator and more! Apr 5, 2024 · What level of education is required for Claims Service Specialists? 48% of Claims Service Specialists have a bachelor's degree, 30% major in business. Posted 9 days ago ·. The CPC exam is a test of medical coding proficiency consisting of 100 multiple-choice questions that assess 17 areas of knowledge. Hybrid work in El Dorado, AR 71730. Mar 14, 2024 · Ability to negotiate and mediate disputes. They record the client’s history and why they are seeking legal services. Explore new Claims Specialist job openings and options for career transitions into related roles. Click here to see the total pay, recent salaries shared and more! Documentation Requirements To validate credentials you may claim, (e. It is the Company's policy to employ the best qualified individuals available for all jobs. Search job openings, see if they fit - company salaries, reviews, and more posted by State Farm employees. Get the right Claims specialist job with company ratings & salaries. Negotiation, in the context of a Claim Specialist, is the process of discussing and reaching a mutually acceptable agreement on the settlement of a claim, involving compromise and dialogue between the involved parties to resolve disputes over claim amounts, coverage, and terms. High school diploma or equivalent. 00 to $17. 222 Claims Specialist jobs available in Remote on Indeed. B. We are seeking a detail-oriented and experienced Claims Specialist to join our team. US Naval Air Systems Command. 26 Claims Service Specialist jobs available in Boise, ID on Indeed. The Claims Specialist’s responsibilities include investigating and reviewing insurance claims, determining the payout amounts, processing claim payments, and identifying irregularities with claim submissions. When an insurance claim is filed, a claims specialist logs the client information, verifies coverage and determines allowable benefits or compensation. Salary: You will begin at the GS-5 or GS-7 level. They must have a high school diploma or equivalent, and some positions may require postsecondary education, such as an Associate's degree in insurance or business administration. Excellent social and communication abilities. Monday to Friday + 2. Provide prompt, courteous service to customers while maintaining a professional demeanor. If you’re looking for a career that offers interesting challenges every day and helps people restore what’s most important to them, consider becoming a claims associate at Nationwide. This process might involve field visits, interviews or research to determine the validity of the claim. Visit www. $43,750. 25 to 30 hours per week. Claims specialists are employed by the claims department of an insurance company. Dec 1, 2022 · A State Farm Claim Specialist typically has a wide range of responsibilities, which can include: Investigate, evaluate, and resolve claims in accordance with company guidelines. Review all insurance correspondence daily to arrive at appropriate claim resolutions. They gather detailed information and review all required documentation, verifying data when necessary. Monday to Friday + 3. Feb 14, 2022 · Learn about the key requirements, duties, responsibilities, and skills that should be in a claims specialist job description. Apr 20, 2021 · Learn about the key requirements, duties, responsibilities, and skills that should be in a claims processor job description. If you're passionate about helping people protect what matters Revere, MA 02151. Sample responsibilities for this position include: Adheres to international privacy policies, practices and procedures and company standards. Refer to . Staff perform work in both individual and group environments. Learn all about Claims Service Specialist educational requirements, degrees, majors, certifications, online courses, and top colleges that will help you advance in a Claims Service Specialist career. Some pursue further education, obtaining Master’s Degrees in related fields to enhance their understanding and skills. Claims adjusters handle a variety of tasks that require individuals to have a strong work ethic, self-discipline and communication skills. Apply to Billing Specialist, Business Associate III, Safety, Health and Environment Assistant and more! The average Insurance Claims Specialist salary in the United States is $46,958 as of April 24, 2024, but the salary range typically falls between $45,126 and $48,962. Patuxent River, MD. Search Claims specialist jobs. Aveanna Healthcare. By following these best practices, you can create a job posting that clearly communicates the requirements and expectations for the role, while also highlighting the benefits and opportunities available to successful candidates. Our Public Claims Specialists receive extensive training and mentoring in Social Security programs and state laws. Senior Attorney Advisor, GS-905-13. g. Responsibility for taking loss facts from the Take a look at these medical claims specialist job specifications for examples of what to include in yours: Associate’s degree in health information technology. Specialists follow up with clients and insurers to resolve issues and Apr 25, 2024 · On average, medical biller coders earn higher salaries than medical claims specialists, with a $3,050 difference per year. $39,576 - $49,025 a year. 76% of claims resolution specialists have a high school diploma, while 31. rdquo; Search Professional liability claims specialist jobs. Remote in Chicago, IL. Just posted ·. Erie Insurance. S-110, Basic Wildland Fire Orientation. Strong customer service skills. By Lee-Shay Newton, Updated Feb 14, 2022. They answer questions, review policies and other documents, and provide guidance to ensure claims are submitted in the proper manner to help ensure prompt and efficient processing. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both). With good performance, you will reach GS-9, the full-performance level, in 1-2 years. An insurance claims specialist made a median hourly wage of over $29. More Mar 14, 2024 · The Copay Support/Claims Processing Specialist will adjudication, troubleshoot claim rejections, claim reversals, allocation deficiencies, identifying group accumulator and maximizers, provide alternate payment processing method, handle paperwork related to medical procedures, treatments and services submitted by the site of care or health care Feb 20, 2024 · Published Feb 20, 2024. Wellness Works Medical Billing. We make the hiring process one step easier by giving you a template to simply post to our Claims Specialists (CS) in the Program Service Center play a vital role delivering Social Security benefits and services to the public. Further career development may lead you to the technical assistant or specialist positions or the Claims Authorizer position. As a CS, you clarify and verify information about initial eligibility for various benefits. **PLEASE APPLY TO BE CONSIDERED**. 5. Ability to work quickly and accurately in a fast-paced environment. 4. Atlanta, GA 30339. 3. A 6-month training program will prepare you for the duties of a Benefit Authorizer. Reconsidering the claim--This is a thorough and independent reexamination of the claim, Apr 5, 2024 · The educational requirements for a claims resolution specialist are a high school diploma or an associate degree. Nationwide’s claims associates thrive on providing the very best service and building lasting, successful relationships with our Aug 11, 2022 · Step 2: Complete an Insurance Licensing Course and Exam. Philadelphia, PA. Remote in Florida. 159 votes for Claims Specialist. Offers a variety of administrative and advisory support functions. Total Loss Specialist job description example 1. Monday to Friday. 76,378 Claims Customer Experience Specialist jobs available on Indeed. Responsibilities for insurance claims specialist. 00 - $18. L-180, Human Factors in the Wildland Fire Service. Mar 14, 2024 · Excellent communication and negotiation skills. At least one year of experience in customer service. Some claims service specialists also hold an associate degree, with 31. , customer time. The lists below show the most common requirements included in claim specialist job postings. Claim ownership for clear liability claims with first party injuries. Conduct follow-up investigation as required by complexity or severity of incident. Claims Specialist Duties & Responsibilities. Provides legal support by assembling documentation for settlement action. Determining if the claim warrants further Logistics Mangement Specialist. Apr 25, 2024 · A claim specialist's role requires attention to detail, organizational skills, and the ability to manage multiple cases. $65,000 - $70,000 a year. Ability to adapt to changing circumstances and priorities. $45,000 - $55,000 a year. They must have a comprehensive understanding of disability benefits programs, rules, and regulations, which can be acquired through specific coursework Sample claims service specialist requirements. Part-time. Must be a US Citizen. Aptitude for data analysis and interpretation. In the United States, the expected salary range for this role is between $40,000 and $70,000 per year, with an average salary of around $55,000. In this article, we will define the role of the medical claims specialist and describe their day-to-day Claim Specialist Skills. Feb 23, 2024 · An intake specialist’s primary duty is to gather specific information whether it be in a legal or care environment. 00 per hour in the same year. Time to Completion: This exam takes up to three hours and has 100 scored Claim Specialists perform work of varying degrees of difficulty and responsibility in the investigation, negotiation and adjustment of claims involving the City or one of its public authorities conducting oral examinations for statutory hearings and utilizing manual, automated and computerized office systems as an integral part of these duties. ), an original or certified copy of the document{s) must accompany each employment application you are applying for with your legal signature. From $26 an hour. m. Claims specialist provides support (or coverage) for the Insurance Claims Representative (s) on Auto & General liability claim intake/initial processing as needed or as required. Minimum of 25 hours per week. Manages acquisition services to acquire goods and services in support of our mission. About the CPB exam. $99,200 - $128,956 a year. Inspects property damage, reviews information to prepare estimates, evaluates and makes recommendations…. Ability to work independently and in a team environment. HOURS OF OPERATION: The anticipated hours of operation will be 7 a. Strong problem-solving and analytical skills. Depending on your state, you may want to take a course, complete it and pass the licensing exam to become an insurance claims representative. hu ou xp fe mm ty mr fk uy wm