Claims Examiner

A company is looking for a Claims Examiner I.

Key Responsibilities

Process and adjudicate healthcare claims, including medical, dental, vision, and mental health claims

Conduct claims investigations, negotiate settlements, and manage overpayment reviews

Resolve claims appeals, research benefits, and verify correct plan loading

Required Qualifications

2+ years of related work experience in claims examination or adjudication

High school diploma or GED

Knowledge of CPT and ICD-9 coding

Familiarity with COBRA, HIPAA, and coordination of benefits

Proficiency in Microsoft Windows and related software for medical coding