Medical Claims Examiner

Job Summary

A company is looking for a Medical Claims Examiner II to support, review, and adjudicate medical claims.

Key Responsibilities

• Accurately review and verify medical claims processing based on policies and procedures
• Assist in training new team members and foster a collaborative team culture
• Provide feedback to leadership on system enhancements and departmental workflows

Required Qualifications

• High School Diploma
• 4+ years of experience in processing or analyzing medical claims
• Strong knowledge of CPT/HCPC and ICD-10 coding rules
• Basic proficiency in Windows-based applications and virtual communication tools
• General knowledge of CMS claims submission regulations