Claims Examiner I

As a Claims Examiner, you will handle processing and adjudication for healthcare claims, including claims research and claim complexity. The role involves day-to-day processing of claims, investigation and overpayment administration, and resolving claims appeals. The ideal candidate will have 2+ years of related work experience, claims examiner/adjudication experience on a computerized claims payment system, and knowledge of CPT and ICD-9 coding.

Requirements

• 2+ years related work experience
• Claims examiner/adjudication experience on a computerized claims payment system in the healthcare industry
• High school diploma or GED
• Knowledge of CPT and ICD-9 coding
• Knowledge of COBRA, HIPAA, pre-existing conditions, and coordination of benefits
• Proven judgment, decision-making skills and the ability to analyze
• Ability to learn quickly and multitask
• Proficiency in maintaining good rapport with physicians, healthcare facilities, clients and providers
• Concise written and verbal communication skills
• Proficiency using Microsoft Windows and Word, Excel and customized programs for medical CPT coding

Benefits

• Medical, dental, vision, life and global travel health insurance
• Income protection benefits: life insurance, Short- and long-term disability programs
• Flexible schedules after training + future WAH options!
• Leave programs to support personal circumstances
• Retirement Savings Plan includes employer contribution and employer match
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits available and a comprehensive wellness program