Claims Examiner

Job Title : Claims Examiner

Location : Remote, Work-From-Home

Reports To : SR. Manager, Operations

Join us in powering the future of pharmacy cost containment!

HelpScript, LLC, an Expion Health Company, has an exciting opportunity for a Claims Examiner in our HelpScript organization. Our team is continuously expanding the boundaries of the healthcare industry through innovations that intersect data and technology and amplifies human intelligence to result in better outcomes. We need people like you to join in our commitment to drive pure exponential value for our clients and partners.

Are you up for the challenge?

Position Summary

The Claims Examiner is responsible for accurately reviewing, processing, and adjudicating claims related to specialty medications, with a focus on applying manufacturer copay assistance and ensuring benefit coordination. This role ensures compliance with payer guidelines, client requirements, and internal policies while maintaining a high level of accuracy and timeliness.

Competencies

• Deliver & Execute (70%) – Demonstrates precision and accountability in processing healthcare claims by consistently meeting accuracy and turnaround standards. Applies policies, copay assistance rules, and benefit coordination with efficiency to ensure timely and compliant claim outcomes.
• Learn & Grow (15%) – Actively seeks opportunities to expand knowledge of healthcare claims, payer policies, and copay assistance programs. Embraces feedback and evolving industry standards to improve accuracy, efficiency, and professional development.
• Plan & Align (15%) – Effectively prioritizes claim workloads and aligns processing activities with organizational timelines, payer requirements, and program goals. Demonstrates foresight in coordinating resources and maintaining compliance to ensure consistent, high-quality claim outcomes.

Essential Functions

Required Expertise

Preferred Skills

Position Type, Work Location & Travel

What It's Like to Work with Us

Expion Health has been challenging the industry status quo for over 30 years, leading with ground-breaking innovation in a wide variety of healthcare solutions. Embracing the latest opportunities that technology can offer within a rapidly evolving industry, we provide exceptional service, technology, and product innovation to meet greater challenges in pharmacy and medical cost management.

We have a distributed workforce so you can work from anywhere in the continental United States. Because of our distributed nature, we have cultivated a connected culture that includes town halls, one-on-ones with executive leadership, educational forums, and even social clubs.

We offer comprehensive benefits package which includes the following :

Expion Health is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.