Claims Coordinator
$50,000–$55,000 year
HybridDurham, North Carolina, United States
Job Summary
Oversee and efficiently process member benefit and insurance claims by verifying coverage, calculating payments, and communicating determinations to members and providers. Review and validate claim submissions for accuracy, coordinate with stakeholders to obtain documentation, and prepare recommendations for carrier determination. Process claims in the department's management system while maintaining accurate records and assisting members through the claims process to resolve discrepancies. Support subrogation efforts and serve as a liaison for emergent cases requiring coordinated assistance. Participate in a rotating on-call schedule for 24-hour emergency benefit verification. Adhere to all policies and procedures outlined in the Employee Handbook.
Required Qualifications
- Bachelor's degree
- 5 years of experience in claims, customer service, or a related field
- Proficiency in Microsoft Office® applications
- Strong verbal and written communication skills, including professional phone etiquette
- Excellent organizational, time management, and problem-solving abilities with strong attention to detail
- Ability to handle sensitive information with confidentiality and professionalism
- Ability to obtain and maintain required insurance licensing
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