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Senior Claims Examiner

Company: VirtualVocations
Location: Provo
Posted on: April 22, 2025

Job Description:

A company is looking for a Senior Claims Examiner to process complex health care claims and mentor team members.
Key Responsibilities

Adjudicate various types of health care claims and ensure compliance with policies and regulations
Research and resolve discrepancies in claims, including communication with providers and members
Lead process improvement initiatives and assist in training other team members

Required Qualifications

High school education or equivalent with 5-7 years of experience as a health claims examiner
Advanced claims processing experience with knowledge of various claim types and regulations
Ability to interpret plan documents for accurate claim adjudication
Proficiency in medical terminology and coding, along with familiarity with relevant forms
Working knowledge of ERISA claims processing guidelines

Keywords: VirtualVocations, Draper , Senior Claims Examiner, Other , Provo, Utah

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