1 Claims Examiner Job in Eau Claire, WI
Hueman PE Talent Solutions is Hiring a Remote Claims Examiner
Benefit Plan Administrators is hiring a fully remote Claims Examiner to join their team!
A Claims Examiner corresponds with policyholders, insurers, and providers to adjudicate claim payments
based on the schedule of benefits stated in the plan documents.
Job Requirements:
- Responsible for claim administration of assigned employer groups in accordance with plan
document and department/company policies and procedures. - Claim administration includes but is not limited to:
Adjudication of new, incoming claims
Adjustments, including denied claims upon receipt of requested information
Appeals
Management of inventory/turnaround time.
Subrogation/Third Party Liability
Meet minimum, established production standards on a monthly basis
Meet minimum, established financial and procedural accuracy standards on a monthly basis
Answers emails and other inquiries within established company timeframes
Ensure claims processed within stop loss contract terms
Follow up on missing/needed information to complete claims
Other duties as assigned
Job Qualifications:
- High School Diploma or G.E.D. equivalent
- At least Three (3) years of experience in insurance claim processing
- Knowledge of CPT Coding
- Knowledge ICD-10 codes
- Basic understanding of medical terminology
- Excellent communication skills
- Excellent customer service skills
- Computer proficiency with office applications
- Ability to comply with all company policies and procedures, proactively protecting the confidentiality of Client and company information
- Ability to work on a computer for a prolonged amount of time
- Ability to work overtime as needed based on industry demands
- Ability to multi-task and prioritize
- Ability to work with minimal direction or supervision
- Legally able to work in the United States
If you are interested in learning more about a career with BPA as a Claims Examiner, apply today!
Job Summary
Full Time
$55k-71k (estimate)
05/18/2024
07/17/2024
The job skills required for Claims Examiner include Customer Service, Subrogation, Claim Processing, Communication Skills, Confidentiality, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Examiner. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Examiner. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Claims Examiner positions, which can be used as a reference in future career path planning. As a Claims Examiner, it can be promoted into senior positions as a Claims Examiner III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Examiner. You can explore the career advancement for a Claims Examiner below and select your interested title to get hiring information.
If you are interested in becoming a Claims Examiner, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Examiner for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Claims Examiner job description and responsibilities
Most medical claims examiners deal with paperwork on a daily basis and they are expected to work on multiple claims per day.
04/03/2022: Springfield, MA
Each claim often comes with supporting documents such as medical records and hospital bills and examiners need to look over each file carefully.
03/08/2022: Manchester, NH
Claims examiners are responsible for approving or rejecting claims or arranging settlements.
01/25/2022: Santa Fe, NM
Examiners may review medical bills or accident reports and they may consult specialists.
01/30/2022: Santa Barbara, CA
The Claims Examiner maintains a full case load of professional liability claims.
01/24/2022: Monroe, LA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Claims Examiner jobs
Keep reading to learn more about a claims examiner role.
03/28/2022: Oklahoma City, OK
Candidates should know that having a critical thinking and outstanding decision-making give examiners the logic and reasoning to evaluate and resolve claims.
04/05/2022: Tulsa, OK
Most employers require or strongly prefer medical claims examiners that have some medical background such as a postsecondary diploma.
03/11/2022: San Antonio, TX
To determine whether a claim should be rewarded, an examiner must be aware of the red flags associated with fraudulent claims and possess detailed analysis skills.
01/30/2022: Bellingham, WA
To begin a career as a medical claims examiner, one must first learn certain knowledge and skills that will help them execute the duties of the job.
02/17/2022: Lawton, OK
Step 3: View the best colleges and universities for Claims Examiner.
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