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Job Title:
Claims Examiner
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Department:
Claims
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Job Description:
Process claims according to policy and state provisions from start to finish. Identify contestable claims for investigation, request needed information, meet required quota on production, and keep quality at a 90% accuracy ratio. Identify and forward certain cases to the Case Manager, and correspond with providers by fax, mail, or phone. Process Individual, Manual, Medicare, Medicaid, Indemnity plans, and other insurance claims.
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Job Requirements:
Regular attendance, teamwork, initiative, flexibility, dependability, accuracy and promptness. Must have 3 years of prior claims investigating experience. Good communication and organizational skills, Medical Terminology, and Coding.
High school diploma or equivalent.
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