Health Claims Examiner (Carmel)

Medical Claims Examiner:
  • Reviews medical claim(s) for completeness and accuracy
  • Manages a caseload of insurance claims to assess their validity or if further investigation is required
  • Consults policy & pertinent files to verify the information reported in a claim
  • Authorizes payment, denies the claim or refers the claim to an investigator for a more thorough review
  • Keeps current files with all the appropriate forms, statements and reports, and maintains medical records, reports and correspondence 
  • Responds to customer inquiries as needed in areas relevant to medical claims status
·        Needs to be detail-oriented, precise and thorough, to be familiar with medical terminology and health insurance administration processes and to have good judgment and integrity
·        Requires a minimum of 1-2 years experience in medical claims processing, medical terminology, ICD10 and CPT knowledge. Experience is Temporary Health Plans/Short Term Medical is a plus.
·        Customer service experience is helpful
·        Exemplary verbal and written communication skills
Working Conditions

·        This position is a Salaried position with a 40-hour work week with hours of operation between 8:30 am-5:00 pm Monday through Friday.
Earnings and Benefits
·        Salary is dependent on experience. This position is eligible for Health, Dental, Vision, Life,  and STD insurance benefits. Paid Time Off is an additional benefit for this position.

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