Claims Examiner

Job Summary

Evaluating insurance claims for validity and compensation, the full-time hourly Claims Examiner will review policy coverage and supporting documentation while ensuring compliance with regulatory requirements in a remote environment.

Key responsibilities

• Review insurance claims for validity and adherence to policy terms
• Collect and analyze relevant documentation, including medical records and accident reports
• Communicate with claimants and stakeholders to explain the claims process and provide updates

Required qualifications

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