Claims Examiner

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee and manage all outgoing calls

• Evaluate HP/AD claims

• Organize tasks and adjudicate claims based on turnaround times

• Investigate, analyze, summarize, and suggest actions on claims

• Ensure claims are processed in accordance with client and company standards

• Continuously assess processes and procedures

• Address and resolve claims submitted via email

⛳️ Requirements

• Proficient English comprehension skills

• Knowledge of mathematics

• Understanding of medical science to interpret medical reports

• Capability to prioritize tasks and adjudicate claims within specified turnaround times

• Ability to independently research, review, summarize, and recommend actions on claims

• Skill in accurately calculating claim amounts for clients

• Adherence to company policies concerning HIPAA, confidentiality, and private health information

🏝️ Benefits

• Competitive salary

• Health insurance options

• Opportunities for professional development