Blue Shield's provider networks are among the largest in California, making it likely that your doctor and any specialists you need are already in our network. Find an Access+ HMO Network Provider. How to find a Personal Physician (Primary Care Physician): Search for a physician (above) and you will be directed to a new page. Then, select Advanced Search and type HMO Personal Physician in the box under Doctor Type or Specialty.
Job Duties of an Insurance Claims Specialist. An insurance claims specialist or claims examiner is responsible for reviewing insurance claims after they are submitted to make sure that proper filing procedures have been followed. Claims specialists may also assist insurance adjusters with complicated or unusual claims.
Claims adjusters, appraisers, examiners, and investigators typically do the following: 1  Investigate, evaluate, and settle insurance claims. 2  Determine whether the insurance policy covers the loss claimed. 3  Decide the appropriate amount the insurance company should pay. 4  Ensure that claims are not fraudulent.