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Medical Claims Examiner Jobs

Claims Examiner Jobs
By Paramount Health Care At Toledo, OH, United States
Responsible for providing workers’ compensation third party administration claims management to Stated-Funded and self-insured employers.
·Participates in other departmental activities as directed by the department manager/director.
1. Previous workers’ compensation experience.
2. Knowledge of medical and legal terminology.
·Assist legal counsel in preparation of Workers’ Compensation cases and attendance at Workers’ Compensation Hearings if necessary.
·Participate in monthly/quarterly claim review with Employers providing detailed reports and claim reviews.
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 Examiner - Fully Remote Position
By Lowe's Companies, Inc. At Mooresville, NC, United States
Maintains a functional knowledge of the relevant laws and legal principles in order to resolve claims
Gathers appropriate information, evaluates alleged damages, determining liability and compensability and negotiating settlements and reporting obtained information
Controls claim costs, provides excellent customer service and resolves complaints to the satisfaction of the customer
Complies with federal and state regulations and service standards
NC Adjuster's Property & Casualty Adjuster's License
Claims Examiner I Jobs
By Western Growers At Irvine, CA, United States
A minimum of one (1)year experience as a Claims Examiner for medical, dental claims and vision, subrogation, and accident claims
Ability to interpret Plan Documents or Summary Plan Descriptions (SPD) for the purpose of accurate claim adjudication and/or benefit determination
Basic knowledge of medical terminology. Familiar with UB-04 and HCFA 1500 forms (837/5010 format), ICD10, CPT, and HCPCS codes.
Good verbal and written communication skills.
Working knowledge of Employee Retirement Income Security Act of 1974 (ERISA) claims processing/adjudication guidelines.
Ensure compliance with all appropriate policies and practices, local, State, Federal regulations and requirements regarding claims and contract administration.
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).
Litigation Claims Examiner - Professional Liability
By Reserv At Atlanta, GA, United States
Attention to detail, time management, and the ability to work independently in a fast-paced, remote environment
Maintaining adjuster licenses and continuing education requirements
Manage litigation cases related to professional lines claims disputes
Passionate adjuster who cares about the customer and their experience.
12+ years of claim handling experience, with 7+ of those years handling a pending of >60% in litigation
You have strong medical knowledge
Secretary/Transcriptionist-Medical Examiner Jobs
By Fort Bend County At Rosenberg, TX, United States
Participates in activities and duties related to emergency management during a local state of disaster as directed by appropriate county managers.
Transcribes complex forensic data from dictation equipment generated during autopsies by Medical Examiners and performs quality assurance.
Prepares various forensic documents, manuscripts and correspondence utilizing a personal computer.
Types moderately complex letters/memos, prepares cremation waivers and burial transit permits regularly.
Oversees the State Death Registration and enters all information on preliminary and amended death certificates, via TxEver.
Scans completed cases and records into electronic system.
Disability Claims Examiner (Remote Role)
By Prudential Financial At South Carolina, United States
Claim/risk management skills and technical knowledge in contract interpretation and administration
2-3 years’ experience in STD claim management required.
Excellent organizational and time management skills
Strong critical thinking skills, communication, organization, and time management skills
Strong written and communication skills demonstrated in previous work experience
Will effectively and accurately manage a block of Complex Short-Term Disability (STD) claims
National Claims Examiner Jobs
By UPCIC At , Fort Lauderdale, Fl
Manage workload and provide management with reports for late reporting according to established UAC guidelines.
Rely on training and guidance from management to plan and accomplish goals.
Possession of other state license as required by management.
Required Knowledge, Skills & Ability
Knowledge of multiple policy forms.
Working knowledge of Microsoft Office including Word, Excel and Outlook.
Recent Actuary Grad - Claims Examiner Working Behind The Scenes In The Healthcare Industry
By All Star Operations At , Remote $18.75 an hour
Recent college graduate with B.S. or B.A. in Math, Actuarial Sciences, Economics, Statistics, Finance, Accounting, or a related field
using your Actuary degree? 100% WORK FROM HOME
Pay: $18.75/hour + Benefits - including medical, dental, vision and 401k w/ matching
Key Responsibilities and Measures of Success:
Detail-oriented and highly organized - a Hermione Granger at heart!
Eager to take on any challenge in front of you
Deputy Director, Medical Examiner, Grade K9
By Fulton County, GA At , , Ga
Specific Knowledge, Skills, or Abilities
Specific License or Certification Required:
Equipment, Machinery, Tools, and Materials Utilization
Fulton County is an Equal Opportunity.
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
Seasonal Storm Claims Examiner
By Farm Bureau Financial Services At , West Des Moines, 50266, Ia
College degree or equivalent required. Experience handling property claims is preferred.
Must have experience with property estimating and construction nomenclature.
Proficiency with Xactimate is required, while XactAnalysis experience is preferred.
Strong customer service skills, including excellent verbal and written communication skills are required.
Must have excellent problem solving, analytical and organizational skills.
Ability to work under pressure and shift priorities to organize and process work with limited supervision under tight deadlines is required.
Claims Examiner Jobs
By Royal Etiquette Services At San Mateo, CA, United States
Strong communication and interpersonal skills to effectively interact with clients and gather information.
Excellent organizational skills with meticulous attention to detail.
Ability to work independently and manage time effectively.
Ensuring accurate and thorough case reports.
Conduct in-person visits to clients' homes to gather accident information, close cases, and perform accident investigations.
Set up a rapport and effectively communicate with clients to collect relevant details and understand their perspectives.
Associate State Medical Examiner
By State of Iowa Talent Gateway At , Ankeny, 50023, Ia $109,408 - $292,094 a year
Participates in appropriate continuing education in order to maintain expertise and licensure.
Maintains complete records of all relevant information concerning deaths or crimes requiring investigation by the State Medical Examiner.
Creates a report on performed postmortem examinations in a timely and accurate manner.
Reviews medicolegal records and uses ancillary tests and consultations when appropriate to complete reports.
Testifies in court and depositions regarding findings and conclusions of postmortem examinations.
Discusses with legal next of kin explaining findings from death investigations.
Claims Examiner I - Evicore - Remote
By The Cigna Group At Bloomfield, CT, United States
Use your knowledge of medical terminology, health insurance plans and medical billing concepts
1 + years of experience with claims processing and/or medical billing - Required.
1+ 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
Medical Disability Examiner Jobs
By The State of Florida At , Miami, 33186, Fl $40,740 - $71,087 a year
Required Knowledge, Skills, and Abilities:
Annual and Sick Leave benefits;
Knowledge of the principles and techniques of effective communication.
Ability to collect, evaluate and analyze data relating to disability benefits.
Ability to understand and apply applicable rules, regulations, policies and procedures relating to disability benefits.
3) Experience working in a medical or vocational field
Pre-Development Specialist / Claims Examiner I
By Health & Human Services Comm At , Austin, 78741, Tx $3,576 - $4,095 a month

Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS

Forensic Toxicologist Iii, Medical Examiner
By Tarrant County, TX At , , Tx $5,559 - $6,115 a month
Tarrant County employees enjoy superior health, retirement, and insurance benefits &
Four (4) full-time years of work experience in a forensic toxicology laboratory or other applicable laboratory experience
Physical Demands and Work Environment & Other Requirements
Performs accessioning, analysis, and evaluation of evidence utilizing standardized and industry acceptable techniques.
Analyzes evidence (biological or other) for the presence of drugs, alcohol, and other analytes and reports results.
Performs routine preventive maintenance on equipment and quality control procedures.
Tdi-Claims Examiner I Jobs
By Texas Department of Insurance At Dallas County, TX, United States

Please paste the following URL into a browser to view the entire job posting in the CAPPS Career Section: https://capps.taleo.net/careersection/ex/jobdetail.ftl?job=00032722 You may apply to the job ...

Are you looking for a challenging and rewarding career in the medical field? Become a Medical Claims Examiner and help ensure that medical claims are processed accurately and efficiently! Join a team of professionals dedicated to providing quality healthcare services to patients and their families.

Overview Medical Claims Examiners are responsible for reviewing and processing medical claims submitted by healthcare providers. They ensure that claims are accurate and complete, and that they meet all applicable regulations and guidelines. They also investigate any discrepancies or errors in the claims, and work with healthcare providers to resolve them. Detailed Job Description Medical Claims Examiners are responsible for reviewing and processing medical claims submitted by healthcare providers. They review claims for accuracy, completeness, and compliance with applicable regulations and guidelines. They investigate any discrepancies or errors in the claims, and work with healthcare providers to resolve them. They also review and process payments for claims, and ensure that all payments are accurate and timely. Job Skills Required
• Knowledge of medical terminology and coding
• Knowledge of medical insurance regulations and guidelines
• Excellent attention to detail
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Ability to work independently and as part of a team
• Proficiency with computers and software programs
Job Qualifications
• High school diploma or equivalent
• Associate’s degree in medical billing and coding or related field preferred
• Certification in medical billing and coding preferred
• Previous experience in medical billing and coding preferred
Job Knowledge
• Knowledge of medical terminology and coding
• Knowledge of medical insurance regulations and guidelines
• Knowledge of medical billing and coding software
Job Experience
• Previous experience in medical billing and coding preferred
Job Responsibilities
• Review and process medical claims submitted by healthcare providers
• Ensure that claims are accurate and complete, and that they meet all applicable regulations and guidelines
• Investigate any discrepancies or errors in the claims, and work with healthcare providers to resolve them
• Review and process payments for claims, and ensure that all payments are accurate and timely
• Maintain accurate records of all claims and payments
• Monitor and update claims status in the system
• Respond to inquiries from healthcare providers regarding claims status