Claims Processor

Reviews, verifies, and processes insurance claims submitted by policyholders to ensure accuracy,completeness, and compliance with company policies and regulatory requirements. Investigatesdiscrepancies or issues by communicating with claimants, insurance agents, healthcare providers, or otherrelevant parties. Determines claim eligibility, calculates payment amounts, and submits claims for approvaland payment processing. Maintains accurate records of claims and documentation, tracks claim progress,and addresses inquiries related to claim status. Ensures adherence to federal and state regulations whilesupporting internal audits and reporting. Provides excellent customer service by assisting claimantsthroughout the claims process.

Created: 2026-01-29