Claims Examiner II

Job Summary

A company is looking for a Claims Examiner II.

Key Responsibilities

• Review and process medical, dental, and vision claims in compliance with regulatory requirements
• Analyze claims and resolve discrepancies by verifying pricing and confirming prior authorizations
• Assist in resolving escalated issues from internal customers and maintain productivity and quality standards

Required Qualifications

• High school education or equivalent with 5-7 years of experience in health claims examination
• A minimum of 2 years' experience specifically in medical, dental, and vision claims
• Knowledge of medical terminology and familiarity with relevant claim forms and codes
• Proficiency in data entry and Microsoft Office applications
• Working knowledge of ERISA claims processing guidelines