Claims Examiner

Job Summary

Working remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii, the full-time Claims Examiner will evaluate claims, ensure compliance with policies, and facilitate the claims process to support healthcare operations.

Key responsibilities

• Evaluate and process claims to determine eligibility and compliance with policies
• Collaborate with healthcare providers and internal teams to resolve claims issues
• Maintain accurate documentation and records related to claims processing

Required qualifications

• Experience in claims processing or a related field
• Knowledge of healthcare regulations and insurance policies
• Proficiency in using claims management software
• Ability to work independently in a remote environment
• High school diploma or equivalent; relevant certifications preferred