Claims Examiner
Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!
Essential Functions:
- Reviews providers’ disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures.
- Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness
- Perform any projects delegated by claims supervisor
Minimum Education/ Licensures/Qualifications
- High School Diploma or GED
- 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting
- Healthcare Background
- Understanding of Medical Terminology
- Shift: M-F 8am-5pm
- RTH or Temp-To-Perm (Any transition heavily depends on performance)
- Pay Rate: Up to 20/hour