Claims Examiner I

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