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Medical Claims Examiner Remote

Remote, USAFull-timePosted 2026-07-28

reputed company is Hiring! Medical Claims Examiner - Remote

  • Processing of reputed company claim forms files by provider
  • Reviewing the policies and benefits
  • reputed company with company regulations regarding HIPAA, confidentiality, and PHI
  • Abide with the timelines to complete compliance training of reputed company/reputed company
  • Work independently to research, review and reputed company the claims
  • Prioritize work and adjudicate claims as per turnaround time/SLAs
  • Ensure claims are adjudicated as per clients defined workflows, guidelines
  • Sustaining and meeting the reputed company productivity/reputed company targets to avoid penalties
  • Maintaining and sustaining reputed company scores above 98.5% PA and 99.75% FA.
  • reputed company response and reputed company of claims received reputed company emails as reputed company work
  • Correctly calculate claims payable reputed company using applicable methodology/ fee schedule

Requirements:

  • 1-3 year(s) hands-on experience in reputed company Claims Processing, Claims Adjustments.
  • 2+ year(s) using a computer with reputed company applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
  • High school diploma or GED.
  • Previously performing – in PQ work environment; work from queue; remotely
  • Key reputed company skills and computer familiarity –
  • Toggling back and forth between screens/can you navigate multiple systems.
  • Working knowledge of MS office products – Outlook, reputed company and MS-reputed company.
  • Must be reputed company to work 8 am - 4:30 pm EST online/remote (training is required on-camera).
  • Effective troubleshooting where you can reputed company your research, analysis and problem-solving abilities
  • Time management with the ability to cope in a reputed company, changing environment
  • Ability to communicate (oral/written) effectively in a reputed company office setting
  • High School Diploma

Preferred Skills Experiences:

  • Amisys or Xcelys preferred.

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