Claims Examiner

Job Summary

A company is looking for a Claims Examiner who will evaluate insurance claims to determine their validity and compensation amounts.

Key Responsibilities

• Review insurance claims for validity, completeness, and adherence to policy terms
• Collect and analyze relevant documentation to support claims processing
• Communicate with claimants and stakeholders regarding the claims process and status updates

Required Qualifications

• High School diploma or equivalent required
• Health claims processing experience required
• Knowledge of medical terminology, ICD-9/ICS-10, CPT, and HCPCS coding preferred
• Familiarity with insurance policies and regulations preferred
• Ability to pass a pre-employment background investigation