Medical Claims Examiner

Job Summary

A company is looking for a Medical Claims Examiner II.

Key Responsibilities

• Review, investigate, and verify coverage for medical claims processing
• Assist in training new team members and support ongoing development
• Provide feedback on departmental workflows and system enhancements

Required Qualifications

• High School Diploma and 4+ years of experience in medical claims processing or analysis
• Strong knowledge of CPT/HCPC and ICD-10 code rules
• Basic proficiency in Windows-based applications
• General knowledge of CMS claims submission regulations
• Demonstrated success in collaborative environments