Health Insurance Claims Examiner

7 hours ago


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

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

Job Summary

Analyze claims to determine insurance carrier liability, interpret contract benefits, and coordinate daily workflow to meet service guarantees. Maintain external and internal contacts with a positive and professional approach.

Primary Responsibilities:
  • Examine and adjudicate claims and written inquiries
  • Interpret contract benefits and claim processing guidelines
  • Understand business concepts and link them to day-to-day claims processing
  • Minimal external contact with providers, agents, and policyholders
Requirements:
  • Good oral and written communication skills
  • Good PC application skills and typing accuracy
  • Previous health/Medicare/prescription claims adjudication experience a plus
  • Organizational and decision-making skills
  • Team-centered with excellent work ethic and reliability
  • Experience with UB/institutional and HCFA/professional claims
  • Familiarity with medical terminology and procedure codes
  • Ability to calculate figures and co-insurance amounts
  • Ability to multitask, prioritize, and problem-solve in a fast-paced environment
About Integrity

We are a leading independent distributor of life, health, and wealth insurance products. We offer a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.

We are committed to meeting Americans wherever they are - in person, over the phone, or online. Our employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide.



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