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)
Claims Examiner II
- (MEM007743)
Title: Claims Examiner II
Location: Fountain Valley
Department: Claims
Status: Full-Time
Shift: Days (8hrs)
Pay Range: $22.41/hr - $32.50/hr
At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.
Position Summary
The Claims Examiner II accurately reviews, researches and analyzes professional, ancillary and institutional inpatient and outpatient claims.
Essential Functions and Responsibilities of the Job
Experience
Education
High School diploma
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