Claims examiner Jobs in Anaheim, CA

A company is looking for a Claims Examiner who will be responsible for verifying, adjudicating, and resolving insurance claims.

Key Responsibilities

Reviews and validates claims for accuracy, completeness, and eligibility based on policy terms and guidelines

Analyzes, adjudicates, and resolves claims by approving or denying documentation and calculating benefit amounts

Ensures legal compliance with company policies and applicable state and federal regulations throughout the claims process

Required Qualifications

High school diploma or equivalent required

Intermediate computer skills, including email, database activity, word processing, and spreadsheets

1-3 years of healthcare reimbursement, claims processing, or customer service experience preferred

Associate's degree or technical college coursework preferred

Familiarity with Medicaid, Medicare, and commercial insurance claims preferred