Claims Specilaist II - Full-time / Part-time

Principal Duties & Responsibilities: - Performs duties using intermediate knowledge of services/products and experience-based judgment to communicate with customers and personnel; performs duties under general direction, working from standard policies and procedures; addresses situations escalated from less experienced claims specialists; escalates more complex situations to more experienced team members or lead specialists - Processes accident claims (wellness, base accident, and disability due to accident), including but not limited to the paying, denying, and pending of claims based on information submitted for review; analyzes billings and supporting medical documentation and uses in-house claims processing systems that include subsystems for diagnosis and