Claims Examiner

Job Summary

Claims Examiner, responsible for accurately processing medical claims in compliance with payer requirements and internal policies in a full-time remote position.

Key Responsibilities

• Review and adjudicate medical claims, ensuring accurate coding and data entry
• Verify patient eligibility and provider credentialing to facilitate claims processing
• Communicate with internal stakeholders to resolve claim discrepancies and request additional information

Required Qualifications

• 1-2 years of experience in healthcare claims processing or adjudication
• Understanding of health claims processing and adjudication
• Familiarity with medical terminology and ICD-9 & ICD-10
• Basic MS Office computer skills
• Ability to work independently or within a team