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Claims Examiner I

7/10/2025

Remote

Job Summary

A company is looking for a Claims Examiner I - Part Time.

Key Responsibilities
  • Process and adjudicate healthcare claims, including medical, dental, vision, and mental health claims
  • Conduct claims research, investigate claims, and manage overpayment administration
  • Resolve claims appeals, verify benefits, and ensure accurate plan loading
Required Qualifications
  • 2+ years of related medical claims examiner/adjudication experience in the healthcare industry
  • High school diploma or GED
  • Knowledge of CPT and ICD-9 coding
  • Understanding of COBRA, HIPAA, pre-existing conditions, and coordination of benefits
  • Proven judgment and decision-making skills with the ability to analyze information

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