Claims Examiner

Job Summary

A company is looking for a Claims Examiner.

Key Responsibilities

• Process and interpret claims based on plan documents
• Review and analyze information to determine eligibility and manage claims
• Investigate suspicious claims and ensure compliance with policies and procedures

Required Qualifications

• High school diploma or GED
• 1+ years' experience in clerical and customer service roles
• Associate degree in Medical Billing and Coding or related field (preferred)
• Experience in claims or medical office settings, with knowledge of medical terminology (preferred)
• TPA experience (preferred)