Claims Specialist

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

900 HOPE WAY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

Job Description:

Responsible for providing professional support to the claims team to ensure the efficient functioning of the department. This position prepares and distributes documents, manages projects, and utilizes organizational and time management skills to complete assignments effectively. Additionally, this role requires outstanding communication and stress management skills to handle daily responsibilities. In addition, this position manages highly confidential information with discretion. This role performs all delegated duties under the general supervision of the claims team.

• Manages and oversees all aspects of the claims process.
• Ensures compliance with federal and state regulations.
• Provides expert guidance on operations intersecting with patient privacy regulations and consumer data protection laws.
• Develops and implements policies and procedures for claims processing. Monitors and evaluates the effectiveness of claims processing activities. Coordinates with legal and compliance teams to address regulatory issues. Conducts training and education for staff on claims processing and compliance requirements.
• Reviews and analyzes claims data to identify trends and areas for improvement. Collaborates with other departments to ensure seamless operations and compliance.
• Investigates and resolves complex claims issues.
• Prepares and submits reports to regulatory agencies as required.
• Stays updated on changes in laws and regulations affecting claims processing. Other duties as assigned.

Knowledge, Skills, and Abilities:
• Skill in using Microsoft Outlook, Word, Excel, PowerPoint. [Required]
• Basic use of online research systems. [Required]
• Basic use of internet. [Required]
• Change management skills. [Required]
• Self-motivator, quick thinker. [Required]
• Strong skills using Microsoft Office Programs. [Preferred]
• Ability to quickly adapt to new situations and responsibilities. [Preferred]
• Strong writing skills. [Preferred]
• Strong organizational skills. [Preferred]

Education:
• Associate [Required]
• Bachelor's [Preferred]

Work Experience:
• 5+ experience in a professional role as a paralegal or related work experience [Required]
• Experience using Lexis/Nexis and Florida Courts filing portal. [Preferred]
• Previous experience as a paralegal. [Preferred]

Licenses and Certifications:
• Certified Paralegal (CP) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/23km2677

Pay Range:

$49,718.59 - $92,468.74

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.