MST Insurance Solutions, Inc.

Claims Specialist

• Provide claims support and advocacy for clients and their employees
• Serve as a liaison between employees, insurance carriers, healthcare providers, and the Account Management Team
• Research claim inquiries and identify causes of claim processing issues and appropriate next steps
• Assist employees with EOB statements, claim status, carrier requests, and claim-related communications
• Assist with denied, incorrectly processed, or outstanding medical, prescription drug, dental, vision, life, and disability claims
• Assist with pre-authorization and prior authorization issues
• Assist with benefit and coverage inquiries by reviewing plan information
• Escalate claim issues with insurance carriers when additional review or intervention is necessary
• Provide timely follow-up, clear communication, and customer service throughout claim resolution

Employee Benefits Claims Coordinator