Medical Claims Examiner II

Overview

Role involves reviewing and adjudicating medical claims while supporting team performance and training.

Ideal candidate has 4+ years of experience in medical claims with strong knowledge of coding rules.

Locations

• United States

Requirements

• High School Diploma
• 4+ years experience in medical claims
• Strong knowledge of CPT/HCPC and ICD-10 codes

Responsibilities

• Review and adjudicate medical claims
• Support team discussions and issue resolution
• Train new team members
• Communicate complex claims issues
• Process complex claim scenarios
• Provide feedback on system enhancements
• Meet department metrics
• Foster a collaborative team culture

Benefits

• Flexible PTO
• Paid parental leave
• 401k program
• Education reimbursement
• Cell phone reimbursement
• Transportation perks
• Paid holidays
• Alternative medicine coverage