Claims Examiner

Job Summary

A company is looking for a Claims Examiner to join their team in Plano, Texas.

Key Responsibilities

• Process professional claim forms and review policies and benefits
• Research, review, and adjudicate claims while adhering to timelines and guidelines
• Maintain quality scores and ensure timely responses to claims received via email

Required Qualifications

• Experience in claims processing and adjudication
• Knowledge of HIPAA regulations and confidentiality standards
• Ability to work independently and prioritize tasks effectively
• Familiarity with claims payable calculations and fee schedules
• Commitment to meeting client productivity and quality targets