Claims Examiner - Remote

Overview

The Claims Examiner is responsible for processing medical claims and providing customer service support to members, providers, and clients in a remote work environment.

In Short

• Process claims in a timely manner with acceptable accuracy.
• Handle correspondence and phone calls from members and providers.
• Analyze self-funded health plans and respond to inquiries.
• Interpret plan design and analyze claim edits.
• Act as the point of contact for clients and members.
• Work on Customer Service Tickets.
• Familiarity with ICD-10 and CPT coding required.
• Understanding of medical claims processing guidelines.
• Proficient in PC skills including email and databases.
• High school diploma with 1-2 years of experience.

Requirements

• Familiarity with ICD-10 and CPT coding.
• Understanding of medical claims processing guidelines.
• Proficient PC skills including email, record keeping, and database activity.
• Experience with QicLink software.
• Knowledge of medical terminology.
• High school diploma and 1-2 years related experience.

Benefits

• Medical, Dental, and Vision insurance.
• Flexible Spending Accounts.
• Gym Membership Reimbursement.
• Life Insurance and LTD/STD coverage.
• 401K plan.
• 3 weeks vacation and 9 paid holidays.
• Casual dress code.