Claims Examiner I
Florida BlueSan Antonio, Texas, United States
Posted May 18, 2026
Full Time
About the Company
Florida Blue is an independent licensee of the Blue Cross and Blue Shield Association, dedicated to serving all Floridians with a range of health solutions. The company offers comprehensive health insurance, wellness programs, innovative health initiatives, and tailored solutions for both individuals and businesses. Florida Blue's core focus on accessibility and quality care sets it apart in the healthcare industry.
Job Description
As a Claim Examiner I, you will handle processing and adjudication for healthcare claims, including claims research and review of insurance coverage. You will also investigate and resolve claims appeals, negotiate settlements, and authorize payments. You will work in an office setting, Monday to Friday, 8:00am - 4:30pm CST.
Requirements
- 2+ years related work experience
- Claims examiner/adjudication experience on a computerized claims payment system
- High school diploma or GED
- Knowledge of CPT and ICD-10 coding
- Knowledge of COBRA, HIPAA, pre-existing conditions, and coordination of benefits
Benefits
- Medical, dental, vision, life and global travel health insurance
- Income protection benefits
- Flexible schedules
- Leave programs
- Retirement Savings Plan with employer contribution and match
- Paid time off
- Volunteer time off
- 11 holidays
- Comprehensive wellness program