Randstad Insurance Claims Adjudication Specialist in Garden City, New York

Insurance Claims Adjudication Specialist

job details:

  • location:Garden City, NY

  • salary:$20 - $25 per hour

  • date posted:Friday, December 7, 2018

  • experience:Experienced

  • job type:Temp to Perm

  • reference:S_711793

  • questions:angela.keeler@randstadusa.com770/303-6674

job description

Insurance Claims Adjudication Specialist

Must have 2 years experience comparing claims to the benefit or coverage requirements and determining whether to pay or deny based on assessment.

Analyze routine insurance claims to determine the extent of the insurance carrier's liability and to settle claims in accordance with the plan provisions

The Claims Specialist sets adequate reserves to ensure proper reporting. Compares data on claim form with insurance plan to ascertain completeness and validity of claim. Examines claim form and other records to determine insurance coverage. Proactively works to resolve claim as expeditiously as possible. Reviews and analyze detailed medical records. Calculates reimbursement of benefits according to the schedule of coverage. Runs various claim reports as directed by the account. Approves claims at the appropriately demonstrated assigned authority level. Handles difficult phone calls. Composes special correspondence. Works on special projects and tasks as assigned.


Writes clearly, concisely and effectively.

Communicates verbally effectively and with impact.

Working hours: 8:00 AM - 5:00 PM


High School Diploma or equivalent -

Claims adjudication experience preferred

Strong communication skills required

Must be computer literate

Detail oriented

Must have ability to multi-task, manage time effectively, be a self starter and work independantly


High School




Full-time position working 8am - 5pm, Monday thru Friday

This is a contract to permanent position.

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.