Claims Specialist: Resolve Medical Claims & Support

Broadspire Services, Inc.; Boise (ID); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Competitive base pay

Total Rewards package

Medical, Dental and Vision plans

Paid Holidays and Vacation

401(k) Retirement Plan

Tuition Assistance

Paid Parental Leave

Supplemental Health Benefits

Wellness programs

Job summary

Crawford & Company is seeking a field-based Senior Administrative Support professional to administer and resolve non-complex claims with limited monetary value. You will document, monitor inventories, verify coverage, and make authority-limited decisions while communicating with claimants and medical professionals.

Ideal candidates hold a college degree or equivalent, with claims knowledge, medical terminology understanding, and a customer-focused approach.

Qualifications

• College degree or the equivalent of education and experience.
• Knowledge of claims terminology and processes gained through industry experience or coursework.
• Thorough working knowledge of claim processing and policies.
• Understanding of medical terminology and tests relevant to claimed conditions.
• Strong written and verbal communication with a customer-focused approach.
• Must maintain required licenses and a valid driver's license; continuing education as required.

Responsibilities

• Investigates and resolves non-complex short-term claims with low monetary amounts.
• Documents and monitors open case inventory and ensures timely closing of files.
• Makes decisions on claims within delegated limited authority.
• Verifies policy coverage, notifies insured of issues, and estimates reserves accordingly.
• Identifies wage loss on medical claims and documents medical reports.
• Communicates with claimants, witnesses, and medical professionals to support processing.
• Completes reporting forms and file documentation; adheres to guidelines.

Skills

Claims knowledge

Medical terminology

Communication skills

Customer-focused

Driver's license

Licensing compliance

Education

College degree or equivalent

Associate in Claim designation

Job description

Crawford & Company is seeking a field-based Senior Administrative Support professional to administer and resolve non-complex claims with limited monetary value. You will document, monitor inventories, verify coverage, and make authority-limited decisions while communicating with claimants and medical professionals.

Ideal candidates hold a college degree or equivalent, with claims knowledge, medical terminology understanding, and a customer-focused approach.