Claims Specialist

IDR; Lehi (UT); On-site; USD 45,000 - 68,000; Full time

Benefits offered by this job

Medical Insurance

Vision Insurance

Dental Insurance

Life Insurance

Job summary

gobravvo, based in Lehi, Utah, is seeking a detail-oriented Claims Specialist to oversee the claims authorization and adjudication process within a leading insurance and claims management organization. You will validate coverage and clearly communicate outcomes, supporting the Claims Operations team and coordinating with contact center staff.

The role emphasizes confidentiality, compliance, and customer service excellence, with opportunities to contribute to process improvements and work in a

Qualifications

• High school diploma or equivalent required.
• Minimum of 2 years experience in claims authorization or a contact center environment.
• Proficiency with Microsoft Office applications including Excel, PowerPoint, and Word.
• Ability to interpret and evaluate complex contract language.
• Excellent communication and analytical skills essential for success as a Claims Specialist.

Responsibilities

• Respond to a high volume of claim authorization requests with professionalism and efficiency.
• Analyze claims to determine eligibility by evaluating diagnosis, product details, and contractual terms.
• Interpret and evaluate contract language to qualify claims for coverage.
• Process cash-settlement offers and coordinate contractor dispatch requests as needed.
• Provide subject matter expertise and escalation support to contact center teams.
• Maintain confidentiality and ensure compliance with all relevant regulations and company policies.

Skills

Detail-oriented

Analytical skills

Communication skills

Contract interpretation

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

The Claims Specialist role is a vital part of the insurance and claims management industry, focusing on the accurate adjudication and authorization of insurance claims. As a Claims Specialist, you will be responsible for overseeing the end-to-end claims process, ensuring that each claim is thoroughly evaluated, validated against contract terms, and effectively communicated to all relevant parties. This position is essential in supporting a Claims Operations team that is dedicated to delivering exceptional customer service and maintaining high standards of integrity and compliance within the claims process.Working as a Claims Specialist offers the opportunity to make a significant impact on the organization and its clients by ensuring that claims are processed efficiently, accurately, and in accordance with policy guidelines. You will collaborate closely with both internal teams and external clients to interpret complex contract language, provide subject matter expertise, and resolve escalations. This role is suited for professionals who are detail-oriented, possess strong analytical skills, and demonstrate a commitment to delivering top-tier customer support within the insurance sector.The Claims Specialist position is ideal for individuals seeking a dynamic, fast-paced environment where no two days are the same. As you manage a high volume of claims authorization requests, you will develop a deep understanding of claims adjudication, policy interpretation, and customer communications. This experience provides a strong foundation for career advancement within the insurance and claims management industry. The role also offers exposure to advanced claims processing technology and opportunities to contribute to process improvements and best practices within the team.Professionals in the Claims Specialist role must demonstrate the ability to work collaboratively with colleagues across departments, including the contact center team and contractor dispatch units. Effective communication is key, as you will be required to deliver clear and concise explanations of claims outcomes, both verbally and in writing. The ideal candidate will also possess a strong sense of ethics and confidentiality, as they will handle sensitive information and ensure compliance with all relevant regulations and company policies.Choosing a career as a Claims Specialist provides the benefit of working with an industry-leading organization, where your skills and expertise are valued and rewarded. The company offers a competitive compensation package, comprehensive benefits, and ongoing professional development opportunities. Employees are encouraged to grow within the organization, supported by dedicated management and access to employee programs such as stock ownership and industry recognition awards.Located in Lehi, Utah, this position allows you to work in a thriving area known for its business growth and vibrant professional community. The local environment fosters collaboration, innovation, and a positive work-life balance.

Join a team committed to excellence, integrity, and client satisfaction in the evolving field of insurance claims management.

Claims Specialist - Summary

Oversees the claims authorization and adjudication process within a leading insurance and claims management organization.

Ensures accurate validation of coverage and effective communication of claims outcomes.

Supports the Claims Operations team and collaborates with contact center staff.

Based in Lehi, Utah, within a dynamic and growing business community.

Duties & Responsibilities

• Respond to a high volume of claim authorization requests with professionalism and efficiency.
• Analyze claims to determine eligibility by evaluating diagnosis, product details, and contractual terms.
• Interpret and evaluate contract language to qualify claims for coverage.
• Process cash-settlement offers and coordinate contractor dispatch requests as needed.
• Provide subject matter expertise and escalation support to contact center teams.
• Maintain confidentiality and ensure compliance with all relevant regulations and company policies.

Salary & Benefits

• Competitive compensation package available for Claims Specialist roles.
• Comprehensive benefits including Medical, Vision, Dental, and Life Insurance.
• Employee Stock Ownership Program for long-term growth and engagement.
• Opportunity to work in an organization recognized for staffing excellence and employee satisfaction.

Qualifications & Requirements

• High school diploma or equivalent required.
• Minimum of 2 years experience in claims authorization or a contact center environment.
• Proficiency with Microsoft Office applications including Excel, PowerPoint, and Word.
• Ability to interpret and evaluate complex contract language.
• Excellent communication and analytical skills essential for success as a Claims Specialist.

Ideal Candidate Snapshot

• Detail-oriented professional with a strong background in claims processing or insurance administration.
• Exceptional problem-solving and analytical abilities.
• Strong communicator with experience supporting contact center operations and resolving escalations.
• Demonstrates integrity, confidentiality, and commitment to customer service excellence.
• Able to thrive in a fast-paced, collaborative team environment.

Other Relevant Information

The company is an industry leader with over 25 years of experience and a reputation for innovation and excellence.

Employees benefit from dedicated engagement management and ongoing professional development resources.

The organization has consistently earned industry awards for staffing and client satisfaction.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

IDR is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations.

In order to comply with these laws, we invite employees to voluntarily self-identify their race or ethnicity, gender, and veteran status (if applicable).

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment.

The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement.