Source Code
Claims Examiner with Decision-Making Expertise
Job Description
Join a dynamic team as a Claims Examiner, where you'll effectively review, calculate, and make decisions on claims to maintain service quality. Your strong judgment will be crucial in meeting performance goals.
This role involves examining claims within the processing unit and making informed decisions based on policy standards. You will also conduct necessary research, enter claims into databases, and communicate with stakeholders to gather essential information. Achieving monthly performance objectives is a key responsibility.
Key Responsibilities:
• Assess and decide on various claims accurately
• Research relevant policies to facilitate decision-making
• Document claims interactions and notes in systems
• Process stop payment requests and reissue payments
• Conduct proactive communications with customers and providers
Requirements:
• Post-secondary education required
• Between 6-12 months of claims examination experience
• Attention to detail and th...
This role involves examining claims within the processing unit and making informed decisions based on policy standards. You will also conduct necessary research, enter claims into databases, and communicate with stakeholders to gather essential information. Achieving monthly performance objectives is a key responsibility.
Key Responsibilities:
• Assess and decide on various claims accurately
• Research relevant policies to facilitate decision-making
• Document claims interactions and notes in systems
• Process stop payment requests and reissue payments
• Conduct proactive communications with customers and providers
Requirements:
• Post-secondary education required
• Between 6-12 months of claims examination experience
• Attention to detail and th...