California Licensed Claims Examiner

Job Summary

A company is looking for a Remote Claims Examiner for California residents only.

Key Responsibilities

• Review insurance claims for validity, completeness, and adherence to policy terms
• Collect and analyze relevant documentation, including medical records and accident reports
• Communicate with claimants and stakeholders to explain the claims process and provide updates

Required Qualifications

• High School diploma or equivalent required
• Health claims processing experience required, including use of QNXT/FACETS software
• Basic mathematical skills and intermediate typing skills
• Knowledge of medical terminology, ICD-9/ICS-10, CPT, and HIPAA regulations preferred
• Ability to pass a pre-employment background investigation