US Healthcare Insurance Process

Spes Manning Solutions is actively seeking dedicated and detail-oriented individuals to join our team as a Healthcare Claims Associate for our US Healthcare Insurance Process . This is a great opportunity to work in a critical and highly-regulated industry, helping customers navigate the complexities of their health insurance. You will be responsible for a variety of tasks, from processing claims to providing direct support to members and providers.

Key Responsibilities

• Process health insurance claims and ensure full compliance with federal and state regulations, such as HIPAA and the ACA .
• Provide support to members regarding policy coverage, billing issues, and provider networks.
• Coordinate with healthcare providers , internal departments, and third-party administrators to resolve issues.
• Perform eligibility verification and enrollment updates accurately.
• Assist with prior authorizations, appeals, and denials when applicable.
• Maintain accurate and timely documentation in internal systems.

Eligibility Criteria

Benefits

How to Apply

To apply for this position, please send your updated resume directly to :

HR ISHA

Skills Required

Insurance Process, Verification, Documentation, Communication Skills, Software Knowledge