Description
The Claims Officer evaluates medical claims from technical and medical perspectives, assesses treatment plans, analyzes provider abuse, fraud, waste, and trends, explains claim decisions to clients, and manages daily claims administration. The role also supports team objectives, service levels, workflow coordination, and deadline management. Applicants need a bachelor’s degree in medicine, dentistry, pharmacy, or nursing, at least two years of medical practical experience, physical fitness, legal work authorization, and fluency with Microsoft Office and internet research.
