Claims Examiner jobs in Columbus, OH
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)
Recently Added Claims Examiner jobs
Claims examiner
- UST
-
Columbus, OH
FULL_TIME
-
Claims Examiner
UST HealthProof is looking for Claims Examiner, reporting to the Claims Team Leader, the Examiner is responsible for adjudication of healthcare claims utilizing employer and payer specific policies and procedures. Responsible for reviewing the data in the claims processing system and compare with corresponding UB04 or CMS1500. Responsible for reviewing claims attachments when necessary to determine if services rendered was medically appropriate and benefit coverage criteria has been met. Responsible for reviewing adjudication software system’s claim and line items edits for determination of whether to pay claim/line item(s).
As a Claims Examiner at UST HealthProof, this is your opportunity to- Be responsible for attending and successfully completing the trainings scheduled by the client and employer
- Be responsible for processing assigned claims based on client specified guidelines or as directed by team lead
- Be responsible for meeting claims productivity targets of claims per hour or day as set by team lead
- Collaborate with other team members on special projects as assigned by the team leads including process documentation, training, quality audit, assist with surge activity for client (s), or any other project as determined by the team lead
- Develop Knowledge of physician practice and hospital coding, billing and medical terminology, CPT, HCPCS, ICD-9 and ICD-10, UB04, CMS 1500, authorization and other terms, terminology and concepts of healthcare
- Develop some level of communication with client Claims managers to address issues, concerns and take preventive measures to avoid service quality issues
- Be responsible for your attendance, time off and reporting shift timings etc. with the prime objective of meeting and exceeding customer deliverables
- Participate in meetings and project activities outside of the primary location at locations determined by UST management team and team lead
- High School degree required with one year of relevant professional experience in Healthcare claims operations for an insurance company or healthcare payor.
- Willingness to learn new skills and succeed in a new career
- Excellent verbal and written communication skills.
- Proficiency with MS Office applications, especially Word and Excel.
- Team collaborator
- ICD-9 and ICD-10 coding is a plus, CPT and HCPCS coding, HIPAA is a plus
- Strong work ethic with ability to multi-task is essential
- High proficiency in using MS Excel and MS Office Suite
- Good understanding and ability to analyze claims data and report, SLA, KPI, operations report and present findings in a structured way
- The ability to adapt quickly to a fast-paced environment, self-starter and quick learner
- Excellent written and oral communication skills
- Team Player and ability to collaborate
Overall Experience level: 0-2 years of operation experience, any healthcare
UST Global celebrates diversity and inclusion. We are an Equal Employment Opportunity employer. We welcome candidates to apply for employment from diverse backgrounds and believe your unique perspective adds to the richness of our company culture. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. - 1 Day Ago
Claims Examiner Assistant
- Universal Fire & Casualty Insurance Company
-
Dublin, OH
FULL_TIME
- Claims Examiner AssistantUniversal Shield Insurance Group (and its member companies – Universal Fire & Casualty Insurance Company (www.ufcic.com) and Shield Indemnity, Inc. (www.shieldindemnity.com) h...
- 7 Days Ago
Claims Assistant
- Sedgwick Claims Management Services Inc.
-
Dublin, OH
FULL_TIME
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flex...
- 26 Days Ago
Commercial Plans Examiner
- Licking County
-
Newark, OH
FULL_TIME
- Company DescriptionLicking County Building Code EnforcementJob DescriptionHours: Full Time, 7:00AM to 4:00PMSalary: $87,360.00 - $95,680.00 Summary:Performs commercial code plan reviews in a way that ...
- 10 Days Ago
Driver License Examiner 1
- State of Ohio Jobs
-
Columbus, OH
FULL_TIME
- Primary Location: United States of America-OHIO-Franklin County-Columbus Work Locations: Alum Creek Facility 1583 Alum Creek Drive Columbus 43209 Organization: Public Safety Classified Indicator: Clas...
- 7 Days Ago
Commercial Title Examiner - Remote in Ohio
- First American Financial Corporation
-
Columbus, OH
OTHER
- Who We AreJoin a team that puts its People First! First American's Agency Division is dedicated to providing our policy-issuing agents with resources, services and underwriting guidance needed to achi...
- 10 Days Ago
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0 Claims Examiner jobs found in Columbus, OH area
Claims Examiner –Remote
- Generis Tek Inc
-
Columbus, OH
- Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
- 4/18/2024 12:00:00 AM
Remote Insurance Agent
- Propel Personnel
-
Columbus, OH
- Job Description Job Description Remote Insurance Agent Job Overview Join one of the nation’s leading Fortune 100 Insuran...
- 4/17/2024 12:00:00 AM
Remote Insurance Agent
- The Abbate Agency
-
Columbus, OH
- The Abbate Agency is seeking individuals looking to start a rewarding career in the insurance industry with room for gro...
- 4/17/2024 12:00:00 AM
Insurance Agent - Remote
- Globe Life: AO Premier
-
Hilliard, OH
- Coming off our record breaking year with over $114 Million in sales, we are looking for competitive, hard working indivi...
- 4/17/2024 12:00:00 AM
Insurance Agent
- Klutz Agency
-
Westerville, OH
- As an insurance agent at the Klutz Agency, you are committed to helping families and individuals protect what matters mo...
- 4/16/2024 12:00:00 AM
Life Insurance Agent
- Barnes Agency
-
Lancaster, OH
- Job Title: Life Insurance Agent Company Overview: Join our dynamic and rapidly growing team at the Barnes Family Agency,...
- 4/16/2024 12:00:00 AM
Remote Insurance Agent
- Primerica
-
Blacklick, OH
- NO PREVIOUS EXPERIENCE NECESSARY. WE WILL TRAIN THE RIGHT PERSON. This position can be fully remote. Great for the stay-...
- 4/15/2024 12:00:00 AM
Remote Insurance Agent
- Dorr Agency
-
Powell, OH
- Looking for your last career stop? Interested in an industry change? Seeking work-life balance? The Dorr Agency is seeki...
- 4/14/2024 12:00:00 AM
About Columbus, Ohio
The confluence of the Scioto and Olentangy rivers occurs just north-west of Downtown Columbus. Several smaller tributaries course through the Columbus metropolitan area, including Alum Creek, Big Walnut Creek, and Darby Creek. Columbus is considered to have relatively flat topography thanks to a large glacier that covered most of Ohio during the Wisconsin Ice Age. However, there are sizable differences in elevation through the area, with the high point of Franklin County being 1,132 ft (345 m) above sea level near New Albany, and the low point being 670 ft (200 m) where the Scioto River leaves...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$47,002 to $62,326
Columbus, Ohio area prices
were up 1.3% from a year ago
were up 1.3% from a year ago