10 Best Claims Examiner Job Descriptions

Claims Examiner Job summary 1

The Claims Examiner reports to the Superviosr of Claims. Claims Examiner 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 will thoroughly review, analyze, and research health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment. The position will assist in resolving issues from providers, customer service, member services, health plan, and other internal customers.

Claims Examiner Duties & Responsibilities 1

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Claims Examiner Requirements & Skills 1

Claims Examiner Job summary 2

Our Claims department is currently seeking an Claims Examiner to manage and oversee file load involving simple to moderate complexity subrogation losses. Provides support, insight and/or direction to field claims reps in the pursuit of subrogation through several methods including direct, arbitration, litigation or collection. Includes communications with payers, attorneys, agent and/or insureds on the cases to achieve a positive and fair outcome. Also includes administrative type procedures instrumental to the Claims Recovery operations.

Claims Examiner Duties & Responsibilities 2

Claims Examiner Requirements & Skills 2

Claims Examiner Job summary 3

The Claims Examiner maintains a full case load of Professional Liability claims. Ideal candidate would have experience handling lawyers, accountants, miscellaneous professional liability claims and/or healthcare claims. Analyzes and reviews claims for accuracy, completeness and coverage. Prepares and maintains reports and records for processing.

Claims Examiner Duties & Responsibilities 3

Claims Examiner Requirements & Skills 3

Claims Examiner Job summary 4

We are searching for a Claims Examiner - someone who works well in a fast-paced setting. In this position, you will process and adjudicate claims received for reimbursement to Providers based on extensive review, research, and a detailed format of claim processing procedures.

Claims Examiner Duties & Responsibilities 4

Claims Examiner Requirements & Skills 4

Claims Examiner Job summary 5

We are looking for a full-time Claims Examiner. Primary duties will be to ensure claim payments are issued in a timely and accurate manner under the terms of various Long Term Care policies (including Nursing Home, Assisted Living, and Home Health Care benefits). Obtain proof of loss documentation from claimants and care providers, analyze information against the policy provisions, and make an independent benefit eligibility determination using professional judgment, skill and policy-interpretation experience.

Claims Examiner Duties & Responsibilities 5

Claims Examiner Requirements & Skills 5

Claims Examiner Job summary 6

The Claims Examiner position is responsible for the investigation, adjustment and settlement of Homeowner Property claims.

Claims Examiner Duties & Responsibilities 6

Claims Examiner Requirements & Skills 6

Claims Examiner Job summary 7

The Claims Examiner reviews and evaluates paper & electronic claims for benefits in accordance with policy provisions

Claims Examiner Duties & Responsibilities 7

Claims Examiner Requirements & Skills 7

Claims Examiner Job summary 8

The Claims Examiner reports to the Superviosr of Claims. Claims Examiner 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 will thoroughly review, analyze, and research health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment. The position will assist in resolving issues from providers, customer service, member services, health plan, and other internal customers.

Claims Examiner Duties & Responsibilities 8

Claims Examiner Requirements & Skills 8

Claims Examiner Job summary 9

The Claims Examiner will process claims for employee benefit and other benefit plans.

Claims Examiner Duties & Responsibilities 9

Claims Examiner Requirements & Skills 9

Claims Examiner Job summary 10

We are seeking a skilled Claims Examiner to handle claims at our growing, innovation-focused company. A qualified candidate will have strong estimating skills, can comfortably handle high severity losses, and distill complex information for customers. You’ll be able to effectively communicate and negotiate across multiple parties, including customers, contractors, and public adjusters. This is a desk-based adjusting position. If you're interested in joining our growing Claims team, we'd love to hear from you.

Claims Examiner Duties & Responsibilities 10

Claims Examiner Requirements & Skills 10

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