Claims Specialist

This position focuses on completing work in the following core areas:

• Coordination and completion of pre-payment quality assurance and post payment verification processes for claim, and adjustments to ensure accuracy of submitted claims and issued payments;
• Investigation and resolution of complex customer service inquiries and technical issues related to claim, claim payments, claim advance and child registration;
• Recommending enhancements to the information system and coordinating testing plan and activities for the system;
• Coordinating, monitoring and reporting on the recovery activities;
• providing input on and drafting policy and training products aimed at both internal and external audiences, and
• Supervision of claim payment coordinators.

RESPONSIBILITIES AND ACTIVITIES

As one of the client Claims Unit key contacts and representatives, the Claims Specialist is guided by program and financial polic...