Claims Examiner

Job Summary

A company is looking for a Claims Examiner to evaluate insurance claims and determine compensation for policyholders.

Key Responsibilities

• Review insurance claims for validity and adherence to policy terms
• Collect and analyze relevant documentation related to claims
• Communicate with claimants and stakeholders to explain the claims process and provide updates

Required Qualifications

• High School diploma or equivalent required
• Knowledge of healthcare claims processing and familiarity with claims systems
• Understanding of HIPAA regulations and basic medical terminology
• Ability to spot discrepancies in claims and review large volumes of data
• Ability to pass pre-employment background investigation and requirements