Claims Examiner

Job Summary

A company is looking for a Claims Examiner who will review and adjudicate claims based on provider and health plan contractual agreements.

Key Responsibilities

• Comply with internal processes and procedures to ensure adherence to departmental policies
• Review, research, analyze, and process complex healthcare claims using multiple computer systems
• Escalate claim and/or system issues to the Team Lead or Supervisor as necessary

Required Qualifications

• High School/GED required; Associate's Degree preferred
• Minimum of 1 year prior claims experience preferred
• Mathematical aptitude and analytical skills
• Demonstrated ability in using computer and Windows PC applications
• Ability to research and investigate information using multiple sources