Claims Examiner - Remote

Overview

The Claims Examiner I is responsible for handling inbound calls from providers and health plans, adjudicating physician claims in a timely and accurate manner while providing superior customer service.

In Short

• Responsible for inbound calls from providers and health plans.
• Adjudicates physician claims accurately and timely.
• Maintains quality and compliance standards.
• Processes medical claims including CPT, ICD, and Revenue Coding.
• Logs all incoming calls and emails correctly.
• Participates in meetings, training, and committees as required.
• Identifies and implements required steps for improvement.
• Meets minimum production and accuracy standards.
• Assists with reports and projects assigned by the supervisor.
• Contributes to the corporation’s quality improvement efforts.

Requirements

• One year of claims processing or customer service experience in managed care.
• Demonstrated minimum of 100 SPM on ten key and 30 WPM typing.
• Excellent verbal, written, and interpersonal skills.
• Consistent accuracy and processing efficiency in work.
• Ability to resolve complex claims problems.
• Detail-oriented approach.
• Preferred: Associate's degree or some college coursework.
• Education from an accredited institution.

Benefits

• Generous benefits package promoting wellness.
• Tuition coverage through the PEAK program.
• Opportunities for career growth and development.
• Supportive work culture.
• Equal opportunity employer.