Benefit Claims Specialist I

AFA American Fidelity Assurance Company; Oklahoma; On-site; USD 36,000 - 60,000; Full time

Job summary

AFA American Fidelity Assurance Company is seeking a Claims Processor to evaluate and process routine claims with accuracy and care in a fast-paced environment. You will communicate with customers and medical providers, applying knowledge of CPT/ICD10 codes and medical terminology to determine coverage and payment.

This role emphasizes customer service and teamwork within the claims department. Strong analytical skills and attention to detail are essential, with a willingness to work overtime as

Qualifications

• High school diploma or GED required.
• Knowledge of medical terminology preferred.
• Proficient in Windows-based software and able to learn new applications.
• Solid understanding of anatomy and physiology.
• Familiarity with CPT and ICD-10 coding.
• Strong analytical skills and judgment.
• Excellent oral and written communication.
• Able to work in a fast-paced environment and be flexible with schedule.
• Team player with professional attitude.

Responsibilities

• Evaluates and processes routine claims such as Diagnostic Testing, Wellness, Physician Expense, URM, GAP, Hospital Indemnity, Medlink, Dental, Triage/Incomplete or Pregnancy claims according to policy and guidelines.
• Provides verbal/written communication to customers to ensure high standards of service and meets department metrics.
• Interacts with customers and medical providers, offering direction and assistance on insurance coverage and needs.

Education

High school diploma or GED

Medical terminology

Analytical skills

Oral and written communication

Team player

Flexibility

Overtime willingness

Tools

Windows OS Basics

Job description

AFA American Fidelity Assurance Company is seeking a Claims Processor to evaluate and process routine claims with accuracy and care in a fast-paced environment. You will communicate with customers and medical providers, applying knowledge of CPT/ICD10 codes and medical terminology to determine coverage and payment.

This role emphasizes customer service and teamwork within the claims department. Strong analytical skills and attention to detail are essential, with a willingness to work overtime as