Claims Examiner

Job Summary

A company is looking for a Claims Examiner I.

Key Responsibilities

• Process and adjudicate healthcare claims, including medical, dental, vision, and mental health claims
• Conduct claims investigations, negotiate settlements, and manage overpayment reviews
• Resolve claims appeals, research benefits, and verify correct plan loading

Required Qualifications

• 2+ years of related work experience in claims examination or adjudication
• High school diploma or GED
• Knowledge of CPT and ICD-9 coding
• Familiarity with COBRA, HIPAA, and coordination of benefits
• Proficiency in Microsoft Windows and related software for medical coding