Medical Claims Examiner

Job Summary

A company is looking for an Examiner I to join their Medical Necessity/Benefits Administration department.

Key Responsibilities

• Enter data from Medical Necessity Review Forms (MNR Forms) and Clinical Quality Evaluator (CQE) worksheets, maintaining production and quality standards
• Verify member eligibility and create patient records while ensuring completeness of MNR forms
• Perform administrative duties, including contacting providers for clarifications and completing daily production reports

Required Qualifications

• High School Diploma or GED certificate required
• 2 years of data entry experience with a minimum typing speed of 10,000 keystrokes per hour
• Working knowledge of computer keyboard and software applications
• Ability to work in a remote environment with a stable internet connection
• Experience in eligibility verification and data processing preferred