Claims Services Processing Specialist

Process medical expense reimbursement requests by validating documentation, assessing eligibility, and calculating reimbursement amounts in line with policy terms and internal procedures. Provide high-quality customer service through urgent, accurate communication with insured parties and related stakeholders. Monitor day-to-day operational risk, escalate issues appropriately to team managers or business leaders, and act as an escalation point for process/product concerns while solving complex cases.