Medical Claims Examiner

2 days ago


Clearwater, Florida, United States Insurance Administrative Solutions, LLC Full time
Job Summary

We 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 Responsibilities
  • Analyze medical claims to determine the extent of insurance carrier liability
  • Utilize applicable policy forms, insurance law, and internal procedures to answer inquiries and process requests for clients and departments
  • Interpret contract benefits in accordance with specific claims processing guidelines
  • Clear understanding of how various functions within the operation relate to and impact each other
  • Process ongoing caseload and make decisions necessary to properly adjudicate those claims
Requirements
  • High school diploma or equivalent required
  • 2+ years of experience in medical claims processing or a related field
  • Strong analytical and problem-solving skills
  • Excellent communication and customer service skills
  • Ability to work in a fast-paced environment and meet deadlines
What We Offer
  • Competitive salary and benefits package
  • Opportunities for professional growth and development
  • Collaborative and dynamic work environment


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