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Senior Claims Examiner
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- The Senior Claims Examiner will process large dollar/complex health care claims, adjustments and contracts that require higher degree of accuracy.
- The Senior Claims Examiner will work on special projects related to provider and plan documents, system upgrades, implementing initiatives to improve claims processing, and turnaround times.
- High school education or equivalent and five (5) to seven (7) years of experience as a health claims examiner or comparable industry experience.
- Advance level (minimum 5 years) of claims processing experience and understanding of medical, dental, FSA, HRA, transplant, coordination of benefits, Medicare, hospital, professional, subrogation, and accident claims required.
- Working knowledge of Employee Retirement Income Security Act of 1974, (ERISA) claims processing/ adjudication guidelines.
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