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