Claims Examiner

Job Summary

Working remotely in a full-time capacity, the Claims Examiner will process medical, dental, and vision claims, interpret plan documents, and ensure compliance with service standards while collaborating with various departments to resolve client inquiries.

Key responsibilities

• Process and analyze claims to determine eligibility and manage workload effectively
• Maintain accurate records of correspondence and track communications with clients
• Ensure quality assurance by monitoring compliance with service standards and participating in process improvement initiatives

Required qualifications

• 1+ years of experience in clerical and customer service roles
• High School Diploma or equivalent; Associate degree in Medical Billing and Coding or related field preferred
• Experience in claims processing or medical office settings, with knowledge of medical terminology preferred
• Proficient in Microsoft Office and possess strong mathematical skills
• Demonstrated organizational and analytical skills, with the ability to prioritize and manage multiple tasks