Claims Examiner

Job Summary

Working remotely on a full-time hourly basis, the Claims Examiner will process medical, dental, and vision claims, interpret plan documents, and provide customer service while ensuring compliance with service standards.

Key responsibilities

• Process and analyze claims to determine eligibility and manage workload
• Provide timely responses to internal and external customer inquiries regarding claims and plans
• 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
• Proficiency in Microsoft Office and strong mathematical skills
• Demonstrated organizational and analytical skills