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Claims Examiner I Jobs in Union, Arkansas

Claims Systems Configuration Associate I - Evicore - Remote
By The Cigna Group At United States
You'll coordinate, define, and review claims system configuration to meet change requirements as approved.
2+ years of claims and health care experience required
1+ years of experience in Claims Systems Configuration required
1+ years of Microsoft Access experience is required
1+ years of experience with SQL required, ability to run SQL queries is a strongly preferred
Advanced experience with MS Office Excel is required
Claims Examiner (Annuities) Jobs
By Transamerica At United States
Strong preference for prior Transamerica experience and/or knowledge of Transamerica Operations
Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
Associate’s degree in a business field or equivalent experience
Excellent communication and customer service skills
Organizational, problem-solving and analytical skills
Review claims and outside sources used in the review.
Claims Administrator I Jobs
By REI At United States
Supports REI’s integrated disability management program.
Apply general logic and critical thinking skills to determine investigation questions unique to the circumstances of the case.
Tracks and maintains OSHA recordkeeping requirements where applicable.
Ensures REI locations have the applicable support documentation to support compliance with REI and State WC requirements.
General knowledge of the Workers’ Compensation, Automobile, and General Liability claims processes.
Three (3) or more years Workers’ Compensation claims experience.
Claims Analyst I Jobs
By Towne Park At United States
Six to twelve months related experience and/or training; or equivalent combination of education and experience.
Ability to manage several projects simultaneously while working under pressure to meet deadlines.
The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
Excellent written communications skills to provide any necessary correspondence with internal and external customers.
Reasonable accommodations may be made to enable individuals with disabilities to perform all functions.
High school diploma or general education degree (GED)
Fitness Reimbursement Examiner I (Remote, $14/Hr)
By American Specialty Health At United States
Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
Ability to effectively organize, prioritize, multi-task and manage time.
Processes reimbursement requests accurately and efficiently.
Reviews all incoming reimbursement requests to verify necessary information.
Enters reimbursement requests and information into a computerized request Processing System.
Maintains all required documentation of reimbursement requests processed and reimbursement requests on hand.
Claims Examiner Jobs
By Health Special Risk, Inc. At United States
Insurance knowledge/experience with medical terms and billing is a plus.
Knowledge of HIPPA, pre-existing conditions, and coordination of benefits required.
Ensure that all claims are handled in a timely manner to meet state-mandated requirements.
Minimum of 3 years of previous claims processing/adjudication experience. Trizetto QicLink or RIMS experience is a plus.
In-depth knowledge and ability to read and interpret medical policies to determine claim eligibility.
Strong detail-oriented and analytical skills.
Claims Examiner (Employee Benefits)
By Transamerica At United States
Strong preference for prior Transamerica experience and/or knowledge of Transamerica Operations
Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims.
Associate’s degree in a business field or equivalent experience
Excellent communication and customer service skills
Organizational, problem-solving and analytical skills
Review claims and outside sources used in the review.
Claims Examiner I - Evicore - Remote
By The Cigna Group At United States
Experience with Plexus Claims Management (PCM), Truist and Cigna Portal preferred
1+ years of experience with eviCore delegated plans with working knowledge of horizon Health plan preferred
1+ years of experience in medical claims processing required
Utilize expertise to appropriately apply claim concepts, rules and departmental practices, ensuring accuracy, and timeliness of claims payment
Confirm member eligibility, claim pricing and verify authorization and service appropriateness.
Follow appropriate workflows to confirm necessary information such as member eligibility and claim pricing
Mpl Claims Examiner Jobs
By JCW At United States
Pursuit of additional certifications such as CPCU, ARMS, or AINS designation is also valued.
The role involves driving litigation by managing the deployment and utilization of defense counsel and identifying suspected fraudulent claims.
Participation in Claims Projects, reserving roundtables, and pre-trial roundtables is required.
Please apply here, or email your resume to [email protected] for further consideration!
Medical Claims Examiner Jobs
By Flex Employee Services At United States
Title: Medical Claim Examiners-Long Term Care - 100% Remote
Pay Rate: $32-$40 per hour (based on experience)
Minimum 2 years previous experience in long term care or disability claims experience or equivalent.
Hours: M-F 8:00 am – 5:00 pm
# of Positions Needed: 15
Claims Dispute Examiner I - Evicore - Remote
By The Cigna Group At United States
1+ years of experience with eviCore delegated plans with working knowledge of horizon Health plan preferred
1+ years of experience in medical claims processing required
Experience with MC400, ICE, NASCO ImageOne preferred
Utilize expertise to appropriately apply claim concepts, rules and departmental practices, ensuring accuracy, and timeliness of claims payment
Confirm member eligibility and claim pricing. Verify authorization and service appropriateness.
Follow appropriate workflows to confirm necessary information to process disputes (i.e. member eligibility and claim pricing).
Claims Representative I Jobs
By Elevance Health At United States
National +50 Miles away from nearest PulsePoint, National +50 Miles away from nearest PulsePoint
Learning the activities/tasks associated with his/her role. Works under direct supervision.
Relies on others for instruction, guidance, and direction.
Work is reviewed for technical accuracy and soundness.
Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.
Researches and analyzes claims issues.
Claims Examiner Ii - Evicore - Remote
By The Cigna Group At United States
Use your knowledge of medical terminology, health insurance plans and medical billing concepts
2 + years of experience with claims processing and/or medical billing - Required.
2+ years of experience with medical terminology and ICD and CPT codes Required
Proficient in data entry and Microsoft Office Products (Word, Outlook, Excel) - Required.
Image one and/or MC400 experience preferred
Review, evaluation and processing of medical claims
Claims Analyst I Jobs
By Towne Park At United States
Six to twelve months related experience and/or training; or equivalent combination of education and experience.
High school diploma or general education degree (GED)
Ability to manage several projects simultaneously while working under pressure to meet deadlines.
The individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
Excellent written communications skills to provide any necessary correspondence with internal and external customers.
Reasonable accommodations may be made to enable individuals with disabilities to perform all functions.
Trainer Cs & Claims I (Remote) For Or & Wa
By Moda Health At United States
Bachelor's degree in Education, Healthcare, or another relevant field. One (1) year of directly related experience may be substituted.
Experience in using Facets and other Moda software preferred.
Demonstrated knowledge of adult learning theories and methodologies.
Excellent reading, oral, and written communication skills, and ability to interact courteously, professionally, and patiently with all persons internally and externally.
Strong interpersonal and diplomacy skills; adept in conflict resolution, group dynamics, and team building.
Excellent presentation skills in a variety of settings.
Claims Analyst I (Monday-Friday; Remote) ($36505.85 - $44328.54 / Year)
By Talentify.io At United States
General knowledge of office procedures and methods
Excellent oral and written communication skills with the ability to understand oral and written instructions
Excellent computer skills including use of Microsoft Office products
Ability to handle large volume of work and to manage a desk with multiple priorities
Ability to manage and uphold integrity and confidentiality of sensitive data
Competitive Compensation & Benefits Package!
Claims Examiner - Commercial Auto
By Questpro At United States
Good organization and time management skills
Responds promptly and effectively to emails, phone calls, messages and incoming correspondence from clients, insureds, retail agents, brokers, and management.
Proficient computer & typing skills - working knowledge of MS Office: Word, Excel, and Outlook
Carrier experience desk adjusting commercial auto claims is strongly preferred
Demonstrated coverage analysis experience required
Prior experience preparing coverage declination letters, ROR letters, technical reports and other documents is required.
Remote Claims Examiner Jobs
By Firstsource Healthcare At , Remote
Multiple computer application usage experience
Health claims processing experience a plus
Knowledge in the following a plus:
Specific qualifications for this medical financial services role include:
High School diploma or GED
Ability to read and interpret general business correspondence, procedure manuals, and specific plan documents
Claims Examiner Jobs
By Firstsource Healthcare At , Remote
Health claims processing experience a plus
Multiple computer application usage experience
Work From Home Claims Analyst-(Health Care)
Here are just some of the benefits you will enjoy in this financial services role:
Specific qualifications for this medical financial services role include:
High School diploma or GED
Default Fha Claims Qa Analyst I
By Vylla At , $22.00 - $26.75 an hour
Excellent written and oral communication, organizational and time management skills.
Ability to communicate effectively with all levels of staff and management both internally and externally.
Moderate knowledge of default claims processes for insurers and investors.
Strong interpersonal skills with a focus on teamwork and quality.
Ability to manage work in order to meet strict deadlines.
Review FHA Part A claims for accuracy within the investor/insurer timeframes.

Are you looking for a challenging and rewarding career as a Claims Examiner I? We are looking for an experienced professional to join our team and help us process and review insurance claims. You will be responsible for ensuring accuracy and timeliness of claims processing, as well as providing excellent customer service. If you have a passion for helping people and a commitment to accuracy, then this is the job for you!

Overview Claims Examiner I is responsible for reviewing and processing insurance claims. They must ensure that all claims are handled in accordance with company policies and procedures. They must also ensure that all claims are paid in a timely manner. Detailed Job Description Claims Examiner I is responsible for reviewing and processing insurance claims. They must review all claims for accuracy and completeness and ensure that all claims are handled in accordance with company policies and procedures. They must also ensure that all claims are paid in a timely manner. They must also investigate and resolve any discrepancies or disputes that may arise. They must also maintain accurate records of all claims and provide customer service to claimants. Job Skills Required
• Knowledge of insurance policies and procedures
• Excellent customer service skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Ability to handle multiple tasks simultaneously
• Attention to detail
• Ability to work in a fast-paced environment
• Computer proficiency
Job Qualifications
• Bachelor’s degree in business, finance, or a related field
• At least two years of experience in claims processing
• Knowledge of insurance policies and procedures
• Ability to work independently and as part of a team
• Computer proficiency
Job Knowledge
• Knowledge of insurance policies and procedures
• Knowledge of claims processing procedures
• Knowledge of customer service principles
• Knowledge of legal and regulatory requirements
Job Experience
• At least two years of experience in claims processing
• Experience in customer service
• Experience in problem-solving
Job Responsibilities
• Review and process insurance claims
• Ensure that all claims are handled in accordance with company policies and procedures
• Investigate and resolve any discrepancies or disputes that may arise
• Maintain accurate records of all claims
• Provide customer service to claimants
• Monitor claims to ensure timely payment
• Communicate with claimants and other parties involved in the claims process