Medical Claims Examiner

1 week ago


Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time
About Insurance Administrative Solutions, LLC

We are a leading provider of comprehensive administrative solutions for the insurance industry. Our business process outsourcing solution helps insurers optimize their administrative workload, bolster their industry expertise, and streamline operations.

Job Summary

We are seeking a skilled Medical Claims Processor to join our team. As a Medical Claims Processor, you will be responsible for analyzing claims to determine the extent of insurance carrier liability, interpreting contract benefits, and making decisions necessary to properly adjudicate claims.

Key Responsibilities
  • Analyze claims to determine the extent of insurance carrier liability
  • Interpret contract benefits in accordance with specific claims processing guidelines
  • Receive, organize, and make daily use of information regarding benefits, contract coverage, and policy decisions
  • Examine, perform, and research to make decisions necessary to properly adjudicate claims and written inquiries
  • Understand broad strategic concepts of our business and link these to day-to-day business functions of claims processing
  • Good PC application skills and typing to 30 wpm with accuracy and clarity of content
  • Previous health/Medicare/prescription claims adjudication experience a plus
  • Experience with UB/institutional (CMS-1450) and HCFA/professional (CMS-1500) claims
  • Familiarity with medical terminology, procedure, and diagnosis codes preferred
  • Familiarity with Qiclink software a plus
  • Must be able to work independently and meet quality and production standards
  • Must have a clear understanding of policy benefits and procedures within the Claims unit
  • Honesty, as well as respect, for the company and its policies and procedures is crucial
  • Experience in medical/insurance preferred
  • Experience with Medicare Supplement preferred
  • Must be local or residing in the nearby area

We offer a collaborative team environment where you can excel and a competitive compensation package. If you are a motivated and detail-oriented individual with a passion for claims processing, we encourage you to apply.



  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    Job SummaryWe are seeking a highly skilled Medical Claims Processor to join our team at Insurance Administrative Solutions, LLC. As a Medical Claims Processor, you will be responsible for analyzing and processing medical claims to determine the extent of insurance carrier liability.Key ResponsibilitiesAnalyze medical claims to determine the extent of...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLCInsurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. Our team of experts delivers value to our clients by providing compassionate customer service, efficient processing, and quality results.Job SummaryWe are seeking a highly skilled...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLC Insurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. We offer a business process outsourcing solution that helps insurers optimize their administrative workload, leverage emerging technologies, and streamline operations. Our team of...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLC Insurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. We offer a business process outsourcing solution that helps insurers optimize their administrative workload, leverage emerging technologies, and streamline operations. Our team of...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLC Insurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. We offer a business process outsourcing solution that helps insurers optimize their administrative workload, leverage emerging technologies, and streamline operations. Our team of...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLCInsurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. We offer a business process outsourcing solution that helps insurers optimize their administrative workload, leverage emerging technologies, and streamline operations.Job SummaryWe...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLCInsurance Administrative Solutions, LLC is a leading provider of comprehensive administrative solutions for the insurance industry. We offer a business process outsourcing solution that helps insurers optimize their administrative workload, leverage emerging technologies, and streamline operations.Job SummaryWe...


  • Clearwater, Florida, United States US Claims Capital LLC Full time

    Job Title: Underwriter - Personal Injury AttorneyWe are seeking an experienced Underwriter to join our team at US Claims Capital LLC. As an Underwriter, you will play a critical role in reviewing personal injury cases for pre-settlement litigation funding nationwide, with a heavy emphasis in NY.Key Responsibilities:Conduct comprehensive evaluations of...


  • Clearwater, Florida, United States US Claims Capital LLC Full time

    Job OverviewPOSITION SUMMARYUS Claims Capital LLC is a distinguished organization dedicated to providing financial advancements to individuals affected by personal injuries and their families. Our objective is to deliver crucial financial assistance to a market that often lacks adequate support, empowering victims to pursue just settlements. We take pride in...

  • Medical Assistant

    4 weeks ago


    Clearwater, Florida, United States CLEARWATER FAMILY MEDICINE AND ALLE Full time

    Job SummaryWe are seeking a highly skilled and compassionate Medical Assistant to join our team at Clearwater Family Medicine and Allergy, PA. As a Medical Assistant, you will play a vital role in providing exceptional patient care and supporting our healthcare team.Key ResponsibilitiesPatient CareGreet patients and check them in for visitsAssist patients...


  • Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time

    About Insurance Administrative Solutions, LLCWe're a leading provider of insurance administrative solutions, driven by a singular purpose: to help people protect their life, health, and wealth so they can prepare for the good days ahead.We're proud of the work we do and the culture we've built, where we celebrate your hard work and support you daily. Our...


  • Clearwater, Florida, United States FrankCrum Full time

    Job OverviewFrankCrum is seeking a highly skilled Unemployment and Garnishment Specialist to join our team. As a key member of our HR services team, you will play a critical role in processing garnishments and unemployment claims, ensuring compliance with state regulations and company policies.Key ResponsibilitiesProcess writs of garnishments and child...


  • Clearwater, Florida, United States Florida One Insurance Full time

    Job OverviewAre you prepared to immerse yourself in the dynamic field of insurance with a lively and enthusiastic team at Florida One Insurance? As a Full-Time Insurance Agent, you will have the chance to demonstrate your problem-solving abilities and customer-focused mindset on a daily basis. This role presents an exciting opportunity to engage with a...

  • Billing Specialist

    4 weeks ago


    Clearwater, Florida, United States Directions for Living Full time

    Job SummaryWe are seeking a skilled Billing Specialist to join our team at Directions for Living. As a key member of our revenue cycle team, you will play a critical role in ensuring the accuracy and timeliness of our billing and claim submissions.Key Responsibilities:Process and post cash payments and payer remittancesPerform routine account receivables...


  • Clearwater, Florida, United States HealthPlus Staffing Full time

    HealthPlus Staffing is seeking a skilled Family Practice-Without OB Physician to join our team in Clearwater, Florida. **About the Role:** We are looking for a dedicated and compassionate physician to provide high-quality patient care in a fast-paced environment. As a Family Practice-Without OB Physician, you will be responsible for delivering...


  • Clearwater, Florida, United States HealthPlus Staffing Full time

    HealthPlus Staffing is seeking a skilled Family Practice-Without OB Physician to join our team in Clearwater, Florida. **About the Role:** We are looking for a dedicated and compassionate physician to provide high-quality patient care in a fast-paced environment. As a Family Practice-Without OB Physician, you will be responsible for delivering...

  • Dental Associate

    2 weeks ago


    Clearwater, Florida, United States GoTu Full time

    Join Our Dental Team as an Associate DentistWe are seeking a skilled and motivated Associate Dentist to join our team at GoTu. As a rapidly growing tech marketplace focused on the dental space, we offer a unique opportunity for dentists to work on their own terms.Our platform allows dentists to accept local permanent and temporary opportunities from their...


  • Clearwater, Florida, United States Suncoast Center Full time

    Job Title: Sexual Assault AdvocateWe are seeking a highly skilled and compassionate Sexual Assault Advocate to join our team at Suncoast Center. As a key member of our team, you will provide critical support and advocacy services to survivors of sexual violence, ensuring their safety, well-being, and empowerment throughout the healing process.Key...

  • Pediatrician

    1 week ago


    Clearwater, Florida, United States Evara Health Full time

    Job SummaryEvara Health is seeking a dedicated and compassionate Pediatrician to join our team of healthcare professionals. As a Pediatrician, you will be responsible for providing high-quality medical care to infants, children, and adolescents in a fast-paced and dynamic environment.About the RoleProvide comprehensive medical care to patients, including...


  • Clearwater, Florida, United States Directions for Living Full time

    Position OverviewCompensation: $18.26 per hour ($38,000 annually)Our Benefits Include:Comprehensive Medical, Dental, Vision, Life Insurance, and both Short and Long Term Disability (100% employer funded for employees).5 Days of Paid Time Off (PTO)11 Wellness Days, including a full week off during the Christmas season.10 Paid Holidays throughout the year.Are...