Claims Specialist I

To learn more about Arkansas Blue Cross and Blue Shield Hiring Policies, please click here . Job Summary The Claims Specialist resolves medical claims that are not automatically adjudicated by the claims processing system in a timely and accurate manner according to divisional standards of quality and productivity. Resolution may include additional investigation or communication in order to obtain necessary information to complete the claim. 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 High School diploma or equivalent. EXPERIENCE Minimum two (2) years' college coursework (48 semester hours) or other equivalent certification with an emphasis in anatomy, medical terminology, math, biology, or a related field. OR minimum one (1) year of related office experience such as claims processing, health insurance, or medical office. Must pass company proficiency test: Claims Assessment ESSENTIAL SKILLS & ABILITIES Oral & Written Communications Strong Interpersonal skills Sound Judgement Decision Making Detail-Oriented Teamwork Dependability LOCATION Work from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota. Preference will be given to current employees and candidates who reside in Arkansas, Utah, Idaho, and North Dakota. Skills • Clinical Judgment• Computer Work• Critical Thinking• Customer Service• Dec