Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
OVERALL RESPONSIBILITIES:
The ICS is responsible for monitoring and follow-up of durable medical equipment claims, orders, and invoices. Additionally, the ICS is responsible for coordinating the timely and accurate follow-up of rejected, denied, underpaid, and delinquent insurance claims. The ICS works to resolve claims issues with the processing teams and management to maximize collections in an ethical and compliant manner as set forth in the company compliance plan.
SPECIFIC DUTIES:
OVERALL RESPONSIBILITIES:
The ICS is responsible for monitoring and follow-up of durable medical equipment claims, orders, and invoices. Additionally, the ICS is responsible for coordinating the timely and accurate follow-up of rejected, denied, underpaid, and delinquent insurance claims. The ICS works to resolve claims issues with the processing teams and management to maximize collections in an ethical and compliant manner as set forth in the company compliance plan.
SPECIFIC DUTIES:
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