Claims Examiner

Job Summary

A company is looking for a Claims Examiner.

Key Responsibilities

• Adjudicate HP/AD claims and handle all outbound calls
• Research, review, and recommend actions on claims appeals or grievances
• Ensure compliance with client/company guidelines and respond to claims received via email

Required Qualifications

• High school diploma, GED, or college diploma verification required
• Experience in handling US HIP claims
• Knowledge of ICD 10, CPT, medical terminology, and medical documents
• Ability to work independently and manage time effectively
• Reliable internet connection and a dedicated remote work location required