Medical Claims Examiner

Job Summary

A company is looking for a Claims Examiner-Medical.

Key Responsibilities

• Review insurance claims for validity, completeness, and adherence to policy terms
• Collect and analyze relevant documentation, including medical records and policy information
• Communicate with claimants and stakeholders to explain the claims process and provide updates

Required Qualifications

• High School diploma or equivalent required
• Health claims processing experience preferred
• Knowledge of medical terminology and coding (ICD-9/ICS-10, CPT, HCPCS) preferred
• Familiarity with insurance policies and regulatory requirements preferred
• Ability to pass pre-employment background checks and drug tests