Claims Specialist

Overview

This role is for a Claims Specialist with DTLA Benefits. It supports the processing of wellness, accident, and vision insurance claims and involves customer support, data entry, and clerical coordination. The posted salary range for the position is $37,000 to $43,680.

Work arrangement

This position may be either on-site or remote depending on where the selected candidate lives within the continental United States.

• Candidates living within 50 miles of the Columbus, GA office are expected to work on-site during their assigned schedule.
• Candidates living more than 50 miles from the Columbus, GA or Columbia, SC offices may work remotely from home within the continental US, though occasional office visits may be requested based on business needs with advance notice.

Key duties

• Review and process wellness, accident, and vision claims in line with established policies and procedures.
• Assess claim validity by checking policy status, patient eligibility, and the supporting medical and related documents.
• Enter claim information accurately, interpret coding and medical terminology, and use multiple administration systems to route claims for payment or further review.
• Deliver responsive service to policyholders, providers, agents, and internal teams by answering claim-related questions and documenting calls and follow-ups.
• Verify information on claim forms and related documents by contacting insured members or other appropriate parties when needed.
• Provide backup support to other teams, maintain databases, and complete assigned clerical tasks such as filing, copying, typing, and information extraction.
• Handle other related assignments as needed.

Success factors

• Strong customer service mindset with the ability to evaluate needs and maintain service quality.
• Working knowledge of administrative and clerical procedures, including file management, records handling, and office terminology.
• Good listening and communication skills, with the ability to ask relevant questions and understand key points clearly.
• Ability to interpret new information and apply it to problem-solving and decision-making.
• Basic mathematical skills for resolving work-related issues.
• Comfort learning new policies, procedures, concepts, or products using appropriate instructional methods.
• Sound time management and a willingness to assist others.

Education and experience

• High school diploma or equivalent is required.
• At least 1 year of work experience is required.
• Experience using Microsoft Office Suite is required.
• Experience with medical terminology is preferred.
• An equivalent combination of education and experience may also be considered.

Bilingual requirement

If this role requires bilingual capability, fluency in Spanish with the ability to translate documents is needed.

Total rewards

The role offers a base salary range of $37,000 to $43,680. Compensation is determined by factors such as education, experience, licensure, certifications, geographic location, and internal pay comparisons. The company notes that new hires are not typically placed at the top of the range so there is room for future salary growth.

Benefits may include medical, dental, and vision coverage; prescription drug coverage; health care and dependent care flexible spending accounts; supplemental Aflac policies for accident, cancer, critical illness, and hospital indemnity at no cost to employees; a 401(k) plan; annual bonuses; and the option to buy company stock.

Additional paid time off and leave support may include 11 paid holidays per year, up to 20 days of PTO for any reason, state-mandated sick leave where applicable, and other eligible leaves of absence such as sick and safe leave, adoption leave, and parental leave.

Location notes

The job is tied to Columbus, GA, with a listed location of GA, US, 31999. The nearest major market is Columbus, GA.

Additional information

Job ID: 9411. The posting end date is June 29, 2026.