Claims Examiner I

Job Summary

A company is looking for a Claims Examiner I.

Key Responsibilities

• Adjudicate various claims types including medical, dental, and vision claims while ensuring compliance with regulatory requirements
• Analyze and verify patient and medical information to determine appropriate claim benefits and resolve discrepancies
• Maintain HIPAA compliance and meet individual and departmental productivity and quality standards

Required Qualifications

• High school education or equivalent with 1-3 years of experience as a Health Claims Examiner or in a comparable role
• Minimum of one year experience as a Claims Examiner for medical, dental, and vision claims
• Basic knowledge of medical terminology and familiarity with relevant claim forms and coding
• Proficient in data entry and Microsoft Office applications
• Working knowledge of ERISA claims processing guidelines