Healthcare Claims Specialist - Remote

Evry Health is seeking a Claims Specialist. Claims Specialists are responsible for the end-to-end claims adjudication process. This includes testing claim configuration and benefit set up to review of the claim form, verification of eligibility, verification of coordination of benefits with other insurance carriers and finalizing claim determination based on the health benefits plan. Claims Specialists have responsibility to audit auto-adjudicated claims to ensure claim accuracy. They also ensure that claims are processed in accordance to State and Federal regulations and meet the company’s contractual obligations. Claims Specialists are responsible for writing and maintaining the desk top procedures associated with claim adjudication. This role reports to the Vice President of Operations with oversight from the Claims Team Leader.