Hybrid Claims Support Specialist

The Doctors Company; Napa (CA); Hybrid; USD 46,436 - 60,947; Full time

Benefits offered by this job

Health, dental, and vision insurance

401(k) with company match

Paid vacation and holidays

Employee assistance program

Job summary

The Doctors Company is seeking an experienced Claims Administrative Specialist to support our Claims team. This hybrid role can be based in Sherman Oaks, CA or Napa, CA, and involves handling electronic claim files, documentation, and communication with members and stakeholders.

You will provide clerical, administrative, and technical support to claims staff, maintain accurate coding and file updates, and assist in data warehouse searches for claims processing and research projects.

Qualifications

• Experience in insurance or healthcare industry preferred.
• Excellent oral and written communication skills.
• Demonstrates organizational skills and attention to detail.
• Strong customer service skills and ability to work on a high performing team.
• Proficiency with Microsoft Word, Excel, and Outlook.
• Ability to follow departmental procedures with accuracy and detail.
• Ability to prioritize workload to meet deadlines.
• Ability to handle confidential PHI in compliance with policy and regulations.

Responsibilities

• Create electronic claim files with accurate data entry after confirming coverage.
• Serve as first point of contact for members, administrators, agents, or brokers.
• Generate letters for file opening and closing to support assigned claim specialists.
• Organize medical records for the claims file and prepare them for expert review.
• Maintain compliance with company standards and guidelines across the claims process.

Skills

Insurance/healthcare experience

Oral and written communication

Organization and attention to detail

Customer service

Microsoft Word

Microsoft Excel

Microsoft Outlook

Procedural adherence

Time management

Handling PHI

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

The Doctors Company is seeking an experienced Claims Administrative Specialist to support our Claims team. This hybrid role can be based in Sherman Oaks, CA or Napa, CA, and involves handling electronic claim files, documentation, and communication with members and stakeholders.

You will provide clerical, administrative, and technical support to claims staff, maintain accurate coding and file updates, and assist in data warehouse searches for claims processing and research projects.