Claims Operations Coordintor

About the role

The Claims Operations Coordinator supports accurate, timely, and efficient claims processing. Key responsibilities include resolving Health Plan demands and cap deduct inquiries, managing refunds and overpayments, and ensuring all claim transactions are thoroughly documented and compliant.

Responsibilities

• Adjudicate claims
• Collaborate with the Claims Letter Correspondence Coordinator
• Partner with Finance on refund accuracy
• Support leadership with expedited requests and operational needs
• Work cross-functionally with internal departments to resolve dependencies and maintain smooth claims workflows

Requirements

This role is ideal for a detail-oriented claims professional with strong analytical skills, deep knowledge of claims processes, and the ability to juggle multiple priorities in a fast-paced managed care environment.