Processing medical claims and handling customer service inquiries, the full-time Claims Examiner will work remotely to ensure timely and accurate claims processing while serving as a point of contact for members and providers. Key responsibilities Process medical claims and correspondence with acceptable accuracy and timeliness Answer inbound calls and handle inquiries from members and providers Analyze self-funded health plans and interpret plan design to address claim edits and inquiries Required qualifications Familiarity with ICD-10 and CPT coding Understanding of medical claims processing guidelines Proficient PC skills, including email, record keeping, and spreadsheet management Experience with QicLink High school diploma with 1-2 years of related experience or equivalent combination of education and experience
Claims Examiner • Athens, Georgia, United States
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