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Claims examiner Jobs in Tulsa, OK

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Claims examiner • tulsa ok

Last updated: 1 day ago

Claims HMO - Claims Examiner 140-1060

community careTulsa, OK, United States
Full-time

The Claims Examiner is responsible for examining claims that require review prior to being adjudicated.The examiner will use their resources, knowledge and decision-making acumen to determine the a... Show more

Sr. Claims Specialist - Commercial Auto BI

philadelphia insurance companiesTulsa, OK, United States
$102,150.00–$120,177.00 yearly
Full-time

Senior Claims Specialist Commercial Auto BI.Philadelphia Insurance Companies, a member of the Tokio Marine Group, designs, markets and underwrites commercial property/casualty and professional lia... Show more

Claims Specialist

kellyTulsa, Oklahoma, US
$17.75 hourly
Temporary

Finding a job that fits your lifestyle isn’t always easy.That’s where Kelly® Professional & Industrial comes in.We’re seeking Claims Specialists for a temporary-to-hire op... Show more

Benefits Review Specialist

beacon resourcesTulsa Metro Area, Oklahoma
$28.00 hourly
Permanent

Job Title: Benefits Review Specialist.Industry: Insurance / Healthcare.Location (city, state): Tulsa, OK.Work Schedule: Mon-Fri, 8am-5pm.Benefits: This position is eligible for medical, dental, vis... Show more

Commercial Auto Claims Adjuster / Examiner - REMOTE

work at home vintage expertsTulsa, OK, US
Remote
Full-time +2
Quick Apply

Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional... Show more

Claims Specialist/Senior Claims Specialist

MCC Mid-Continent Casualty CompanyTulsa, OK
Full-time +1

Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and difficult-to-place business in other i... Show more

Prebill Claims Specialist

trinity employment specialistsTulsa, OK, US
$20.00 hourly
Full-time
Quick Apply

Trinity Employment Specialists is seeking a.This position is responsible for reviewing patient accounts prior to claim submission, resolving billing edits, verifying patient and insurance informati... Show more

Claims Director

mid continent groupTulsa, OK, United States
Full-time +1

Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and d... Show more

PLANS EXAMINER I-BUILDING PLANS REVIEW (PROGRESSION)

city tulsaTulsa, USA
Full-time

Must meet the following criteria: (a) Graduation from an accredited medical school with an unrestricted license to practice medicine in the State of Oklahoma, and current board certification in Fam... Show more

Warranty Claims Representative I

aaonTulsa, OK, United States
Full-time

Manage manual claims process for entry into warranty website.Process and maintain warranty paperwork to ensure proper documentation and criteria for claims.Delivers a high level of customer service... Show more

Property Adj Large Loss

mercury generalTulsa, OK, United States
$123,077.70–$150,428.30 yearly
Full-time

Join an amazing team that is consistently recognized for our achievements and culture, including our most recent Forbes award of being one of America's Best Midsize Employers for 2026!.Mercury Insu... Show more

Claims Examiner - Remote

beacon resourcesTulsa Metro Area, Oklahoma
$28.00 hourly
Remote
Permanent

Industry: Insurance / Healthcare.Location (city, state): Tulsa, OK (remote).Work Schedule: Mon-Fri, 8am-5pm.Benefits: This position is eligible for medical, dental, vision, and 401(k).Our client is... Show more

Claims Director

great american insurance groupTulsa, OK, United States
Full-time +1

Mid-Continent Group, a subsidiary of Great American, based in Tulsa, Oklahoma, specializes in commercial casualty coverages with an emphasis on general liability for the construction, energy, and d... Show more

Unemployment Insurance Claims Specialist

state oklahomaTulsa, OK, United States
$40,948.00–$45,423.79 yearly
Full-time

Unemployment Insurance Claims Specialist.Agency: 290 Employment Security Commission.Primary Working Hours: M-F; 8:00am 5:00pm.Position Summary of Responsibilities.Assist customers with unemploymen... Show more

Claims Adjuster (Workers' Compensation)

saint francis health systemTulsa, OK, United States
Full-time

Reports to the Worker's Compensation Attorney, the Claims Adjuster is responsible for all processes related to Workers' Compensation claims.Minimum Education: High School Diploma or GED.Licensure, ... Show more

Adjuster- Tulsa Office

oklahoma farm bureau insuranceTulsa, OK, US
Full-time
Quick Apply

Investigate insurance claims; obtain all necessary information to evaluate claims and expedite settlement.Candidate will be required to live within the Tulsa Claims Territory, which contains the fo... Show more

Benefits Review Specialist

addison groupTulsa, OK, United States
$28.00 hourly
Permanent

Industry: Insurance / Healthcare.Location (city, state): Tulsa, OK.Work Schedule: Mon-Fri, 8am-5pm.Benefits: This position is eligible for medical, dental, vision, and 401(k).Our client is an estab... Show more

Entry Level Medical Billing Assistant

revel staffingTulsa, Oklahoma, United States
Full-time
Quick Apply

The Medical Billing Assistant will help prepare and review insurance claims, assist with basic billing and coding tasks, update patient and insurance information, and support the administrative wor... Show more

Unemployment Insurance Claims Specialist

oklahoma school for the blindTulsa, OK, United States
$40,948.00–$45,423.79 yearly
Full-time

Unemployment Insurance Claims Specialist.Agency: 290 Employment Security Commission.Primary Working Hours: M-F; 8:00am 5:00pm.Position Summary of Responsibilities.Assist customers with unemploymen... Show more

Rep, Mobile Examiner - (P/T) - ExamOne/Tulsa, OK area

quest diagnosticsTulsa, OK, United States
Full-time

Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and o... Show more

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Claims HMO - Claims Examiner 140-1060

Claims HMO - Claims Examiner 140-1060

community careTulsa, OK, United States
19 days ago
Job type
  • Full-time
Job description

Claims Examiner

The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency.

Key Responsibilities:

  • Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in determining appropriate actions.
  • Identify claims requiring additional resources and route to the team lead, supervisor or other departments as needed.
  • Enter claims information using the processing software to compute payments, allowable amounts, limitations, exclusions and denials.
  • Identify and communicate trends or problems identified during adjudication process.
  • Contribute to the creation of a pleasant working environment with peers and other departments.
  • Assist in investigating and solving claims that require additional research.
  • Consistently learn and adapt to changes related to claims processing, benefits, limits and regulations.
  • Perform other job-related duties as assigned.

Qualifications:

  • Self-motivated and able to work with minimal direction.
  • Ability to read and understand claims processing manuals, medical terminology, CPT codes, and perform basic processing procedures.
  • Ability to read and understand health benefit booklets.
  • Demonstrated learning agility.
  • Successful completion of Health Care Sanctions background check.
  • Knowledge in the contracted managed care plan terms and rates.
  • General understanding of unbundling methods, COB, and other over-billing methodologies.
  • Must have high attention to detail.
  • Proficient in Microsoft applications.
  • Ability to perform basic mathematical calculations.
  • Possess strong oral and written communication skills.

Education/Experience:

  • High School Diploma or Equivalent required.
  • Two years related work experience in claims processing, claims data entry or medical billing OR medical related education to meet minimum two years required.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin