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Claims Specialist in East Garden City, NY at CRS Group

Date Posted: 3/1/2018

Job Snapshot

Job Description

Claims Specialist
Duration: 6 month contract
Location: Garden City, NY
Overview: The CRS Group is currently looking for a Claims Specialist for one of our clients in the Garden City area. The CRS Group is a nationwide Staffing Firm who works primarily with Fortune 500 and Fortune 1000 corporations.
Duties and Responsibilities:
  • Analyze routine insurance claims to determine the extent of the insurance carrier's liability and to settle claims in accordance with the plan provisions
  • The Claims Specialist sets adequate reserves to ensure proper reporting
  • Compares data on claim form with insurance plan to ascertain completeness and validity of claim
  • Examines claim form and other records to determine insurance coverage
  • Proactively works to resolve claim as expeditiously as possible
  • Reviews and analyze detailed medical records
  • Calculates reimbursement of benefits according to the schedule of coverage
  • Runs various claim reports as directed by the account
  • Approves claims at the appropriately demonstrated assigned authority level
  • Handles difficult phone calls
  • Composes special correspondence
  • Works on special projects and tasks as assigned
  • Other duties as assigned

  • Claims adjudication experience or relevant Berkely experience
  • Writes clearly, concisely and effectively
  • Communicates verbally effectively and with impact
  • Computer literate
  • Detail oriented
  • Ability to multi-task Manages time effectively
  • Committed to superior customer servicing
  • Ability to work independently, a self- starter

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Qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or genetic information.