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Claims Examiner I

Skills
10-Key TypingAccident ClaimsClaims ProcessingCoordination Of BenefitsERISAFederal RegulationsHCFA
Role

What the job involves

The main requirements, responsibilities and hiring steps.

Requirements

  • High school diploma or equivalent with 1-3 years of industry experience in claims examination.
  • Proficient in 10-key by touch and capable of typing 40 WPM.
  • Knowledge of medical terminology, and familiar with HIPAA guidelines and regulations.

Nice to have

  • ERISA knowledge
  • HCPCS coding
  • 10-Key proficiency

Day to day

  • Analyze and process various types of claims including medical, dental, and vision.
  • Ensure accurate claims administration according to ERISA guidelines and state laws.
  • Communicate effectively with healthcare providers to gather necessary documentation and resolve issues.