About The Position

Medical Claims Specialist helps ensure claims are handled accurately and thoughtfully, so people can focus on getting the care they need without stress, confusion, or unexpected costs. In this role, you will: Serve members, clients, providers, and internal operations teams who rely on clear, accurate claims processing Be responsible for getting claims right, resolving issues, and protecting the trust our members place in us Directly impact how supported, confident, and cared for families feel when navigating healthcare This is a hands-on role for someone who: Enjoys detail-oriented work and solving problems that matter to real people Takes ownership and follows through Wants their work to have real-world impact

Requirements

  • 1 year of experience in medical claims processing, Required.
  • Proficiency in Microsoft Word, Excel, and Electronic Medical Record (EMR) systems, Required.
  • Ability to meet production and quality standards consistently.
  • Solid knowledge of Microsoft Excel and Word.
  • Professional, client-focused approach to colleagues and assignments.

Responsibilities

  • Making sure medical claims are reviewed and processed accurately, so members aren’t left waiting or wondering what happens next
  • Supporting members and providers by answering questions and resolving claim issues with clarity and care
  • Collaborating with Third-Party Administrator (TPA) partners, providers, and internal operations teams to keep things moving smoothly
  • Improving claims accuracy, turnaround time, and the overall experience for members navigating care
  • Advocating for members by making sure their claims are handled correctly and fairly the first time

Benefits

  • $0 monthly premiums
  • $0 to add your spouse or children
  • $0 deductibles (we reimburse them)
  • $0 out-of-pocket maximums
  • Dental & Vision insurance
  • Paid time off & sick time
  • 401(k) access
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