Claims Examiner

Position : Claims Examiner

Location : Canfield Ohio 44406 (Onsite)

Duration : FullTime (Permanent Role)

Interviews will be onsite

Job Description:

The Claims Examiner position is responsible for processing medical dental and vision claims.

Review and process medical claims according to Plan guidelines within established turnaround time frames

Interpret medical plan to assure system is coded correctly

Review claims for legitimacy and accuracy

Meet production and quality standards set for examiners

Work Customer Service inquiries related to claim questions

Review correspondence submitted by members and providers and adjust all related claims if the additional documentation submitted warrants adjustment

Other duties as assigned

Qualifications:

High School/GED required

Demonstrate skills in problem solving and benefit plan interpretation

Knowledge of CPT codes ICD10 codes and/or medical terminology is a plus

Ability to work independently

PC proficiency

Average typing ability

1 years prior work experience in health care administration