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 providing exceptional customer service.

Key responsibilities

• Process, analyze, and determine eligibility for claims based on plan provisions
• Maintain accurate records of correspondence and manage inquiries and appeals
• Collaborate with cross-departmental teams to improve quality and streamline procedures

Required qualifications

• High School Diploma or GED required; Associate Degree in Medical Billing and Coding preferred
• 1+ years of clerical and customer service experience required
• Claims or Medical Office experience preferred
• Knowledge of medical terminology preferred
• Proficient in Microsoft Office and basic computer skills