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Claims Examiner I
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- The Claims Examiner I reports to the Supervisor of Claims.
- Claims Examiner I is responsible for reviewing and processing medical, dental, vision and electronic claims in accordance with state, federal and health plan regulatory requirements, department guidelines, as well as meet established quality and production performance benchmarks to include research and review of applicable documentation.
- The Claims Examiner I will thoroughly review, analyze, and research health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment.
- High school education or equivalent: minimum one (1) to three (3) years year of experience as a Health Claims Examiner or comparable industry experience preferred.
- A minimum of one (1)year experience as a Claims Examiner for medical, dental claims and vision, subrogation, and accident claims
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