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 research, investigate overpayments, and facilitate negotiations for settlements
• Resolve claims appeals and verify correct plan loading and benefits

Required Qualifications

• 2+ years of related work experience in claims examination or adjudication in the healthcare industry
• High school diploma or GED
• Knowledge of CPT and ICD-9 coding
• Understanding of COBRA, HIPAA, and coordination of benefits
• Proficiency in Microsoft Windows and Word, Excel, and medical CPT coding programs