Nebraska Licensed Claims Examiner
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Job Summary
Working remotely in Nebraska, the full-time Nebraska Licensed Claims Examiner will analyze and adjudicate healthcare claims, ensuring compliance with policies and guidelines while maintaining production and quality standards.
Key responsibilities
- Interpret claim adjudication rules to process and adjust complex claims accurately and timely
- Review medical documentation and member benefit coverage to determine payment liability
- Collaborate with team members and provide guidance to less experienced claims examiners
Required qualifications
- High School degree
- Proficiency as a Claims Examiner I or relevant healthcare experience
- Experience with MS Office applications
- Ability to work with minimal supervision and multi-task effectively
- Strong work ethic and creative problem resolution skills related to healthcare claim adjudication
Complete Job Description
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