Florida Licensed Claims Examiner

Job Summary

A company is looking for a Claims Examiner.

Key Responsibilities

• Adjudicate HP/AD claims and handle all outbound calls
• Research, review, summarize, and recommend actions on claims with appeals or grievances
• Ensure compliance with client/company guidelines and respond to claims received via email

Required Qualifications, Training, and Education

• Experience in handling US HIP claims
• Knowledge of ICD 10, CPT, surgery procedures, and medical terminology
• Experience in reading and comprehending medical documents
• Basic math knowledge for calculating claim amounts
• Ability to work independently and manage work pressure effectively