Claims Examiner
3 months ago
Day to Day:
The Claims Examiner 1 is responsible for ensuring claims are coded and processed correctly and for meeting production requirements. They will need to process claims by performing the following duties: Adjudicating medical claims, applying coordination of benefits as outlined in plan guidelines, and work with providers to gather the necessary documents to make final payment determination on claims, etc.
Must Haves:
- 3+ years’ experience in the employee benefits industry as a Full Cycle Medical Claims Examiner Processor.
- Proficient in ICD-10, CPT, and HCPCS codes.
- Computer skills, including Word, Excel, and Outlook.
- Written and verbal communication skills.
Plus:
- Associate's degree (A. A.) or equivalent from a two-year college or technical school or equivalent combination of education and experience.
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