Claims Examiner I

Job Summary

To support the Claims department, the remote Claims Examiner I will accurately verify and process claims data from CMS 1500 forms, ensuring compliance with regulations and maintaining production standards in a full-time capacity.

Key responsibilities

• Processes and adjudicates claims accurately and efficiently, maintaining required documentation
• Verifies member and provider records to ensure correct claims processing
• Maintains production standards, processing an average of 31 claims per hour with a 98.5% accuracy rate

Required qualifications

• High School Diploma or GED certificate required
• 6 months of data entry experience with a minimum of 10,000 keystrokes per hour
• Experience processing medical claims and knowledge of medical billing terminology preferred
• Proficient in MS Office
• Ability to work effectively in a work-from-home environment