Disability Claims Examiner, Sr. jobs in Birmingham, AL

Disability Claims Examiner, Sr. reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner, Sr. has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner, Sr. typically reports to a supervisor/manager. To be a Disability Claims Examiner, Sr. typically requires 2 to 4 years of related experience. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. (Copyright 2024 Salary.com)

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Claims Examiner II
  • Viva Health
  • Birmingham, AL FULL_TIME
  • Claims Examiner II

    Location: Birmingham, AL

    Work Schedule: After a period of 100% onsite training, this position will transition to mostly remote with occasional work needed at the Viva Health headquarters in downtown Birmingham.  

    Why VIVA HEALTH?

    VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

    VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan, receiving a 5 out of 5 Star rating - the highest rating a Medicare Advantage Plan can achieve and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

    Benefits

    • Comprehensive Health, Vision, and Dental Coverage
    • 401(k) Savings Plan with company match and immediate vesting
    • Paid Time Off (PTO)
    • 9 Paid Holidays annually plus a Floating Holiday to use as you choose
    • Tuition Assistance
    • Flexible Spending Accounts
    • Healthcare Reimbursement Account
    • Paid Parental Leave
    • Community Service Time Off
    • Life Insurance and Disability Coverage
    • Employee Wellness Program
    • Training and Development Programs to develop new skills and reach career goals
    • Employee Assistance Program

    See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

    Job Description

    The Claims Examiner II will administer all claims adjudication processing professional and facility medical, dental and vision claims in accordance with regulatory guidelines and contractual agreements based on VIVA HEALTH guidelines. This position will assist with additional duties such as reports, following up with departments on routed claims and other duties assigned by management.

    Key Responsibilities

    • Adjudicate claims submitted by providers and members assigned via claims workflow.
    • Reviewing claims for required information, pending claims when necessary, maintaining a follow-up system, and updating and releasing pending claims when indicated.
    • Correctly match authorizations to ensure claims are processing appropriately based on established guidelines.
    • Understand how different processes drive benefit determinations for different claims types based on authorization code sets and claims types.
    • Work with internal departments to resolve issues preventing claims from processing or enhancing processing capabilities.

    REQUIRED:

    • 2 years’ college or equivalent claims adjudication experience
    • 1–2 years’ experience with claims processing
    • Ability to thrive in a production environment where quality and quantity are highly measured, including recognizing and correcting quality errors
    • Demonstrate excellent customer service skills through written and verbal communication
    • Organized, detail oriented and skilled at prioritizing and multitasking
    • Ability to work in a team environment, remain flexible to changes, and recognize responsibilities, actively participate with others to accomplish assignments and achieve desired goals
    • Knowledge of medical terminology, ICD, CPT, and HPCS
    • Basic computer skills including Microsoft Word, Excel, Outlook
    • Understanding of Claims Payment System in order to process claims, prepare reports, and correspondence

    PREFERRED:

    • Professional and/or hospital claims adjudication experience, preferably in the healthcare/medical field
    • CRT data entry experience
  • 7 Days Ago

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AL - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Birmingham, AL FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
  • 7 Days Ago

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Disability Assessor - Cardiff
  • Capita Personal Independence Payment (PIP)
  • Cardiff, AL FULL_TIME
  • Company DescriptionDiscover a new kind of career in healthcare as a disability assessor Working in healthcare, and looking for a change? If you’re a nurse, occupational therapist, physiotherapist or p...
  • 13 Days Ago

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Materials Examiner and Identifier (Forklift Operator)
  • Defense Logistics Agency
  • Anniston, AL FULL_TIME
  • Summary See below for important information regarding this job. 16 hours ago
  • 19 Days Ago

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Internal Revenue Agent (Examiner) 12-Month Roster
  • Internal Revenue Service
  • Birmingham, AL FULL_TIME
  • Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT information. WHERE CAN I FIND OUT MORE ABOUT OTHER IRS CAREERS? Visit us on the web at w...
  • 19 Days Ago

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Materials Examiner and Identifier (Fork Lift Operator)
  • US Defense Logistics Agency
  • Anniston, AL FULL_TIME
  • Duties Receives, examines and determines the condition and disposition of a wide variety of materials. Reviews disposal turn-in document accompanying material. Compares data against property assuring ...
  • 1 Month Ago

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0 Disability Claims Examiner, Sr. jobs found in Birmingham, AL area

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Medical Instrument Technician (Echocardiography Technician)
  • Veterans Health Administration
  • Birmingham, AL
  • Summary The Birmingham VA, Nursing Acute Care Service is seeking a full-time Medical Instrument Technician (Echocardiogr...
  • 3/28/2024 12:00:00 AM

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Insurance Accountant Manager
  • McGriff
  • Birmingham, AL
  • Independently perform or coordinate a variety of advanced accounting activities, including more complex accounting proce...
  • 3/28/2024 12:00:00 AM

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Registered Nurse (CCU-MICU-SICU)
  • Veterans Health Administration
  • Birmingham, AL
  • Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement ...
  • 3/26/2024 12:00:00 AM

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Insurance Sales Agent
  • DiCapua Insurance Group
  • Birmingham, AL
  • Job Description Job Description We are an independent agency providing Property & Causality (auto, home, business + life...
  • 3/26/2024 12:00:00 AM

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Insurance Benefits Consultant
  • JM Recruiting
  • Birmingham, AL
  • Job Description Job Description Are you looking to take your career in a new direction or are you already a licensed ins...
  • 3/26/2024 12:00:00 AM

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Medical Instrument Technician (Diagnostic Ultrasound)
  • Veterans Health Administration
  • Birmingham, AL
  • Summary The Birmingham VA, Diagnostic Imaging Service is seeking a full-time Medical Instrument Technician (Diagnostic U...
  • 3/25/2024 12:00:00 AM

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HR Benefits Administrator
  • Spherion
  • Pell City, AL
  • Responsible for employee benefits and general HR Responsibilities: Administers policies and procedures in all phases of ...
  • 3/25/2024 12:00:00 AM

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Licensed Independent Medicare Insurance Agent - Remote
  • Assurance
  • Birmingham, AL
  • Medicare agents - sell Medicare Advantage, Medicare Supplement and PDP from home this AEP! Assurance is looking for lice...
  • 3/25/2024 12:00:00 AM

Birmingham (/ˈbɜːrmɪŋhæm/ BUR-ming-ham) is a city located in the north central region of the U.S. state of Alabama. With an estimated 2017 population of 210,710, it is the most populous city in Alabama. Birmingham is the seat of Jefferson County, Alabama's most populous and fifth largest county. As of 2017, the Birmingham-Hoover Metropolitan Statistical Area had a population of 1,149,807, making it the most populous in Alabama and 49th-most populous in the United States. Birmingham serves as an important regional hub and is associated with the Deep South, Piedmont, and Appalachian regions ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disability Claims Examiner, Sr. jobs
$54,116 to $70,121
Birmingham, Alabama area prices
were up 1.3% from a year ago

Disability Claims Examiner, Sr. in Memphis, TN
Claims examiners work for insurance companies and they are trained from the beginning to ask questions in such a way to elicit certain information.
December 30, 2019
Disability Claims Examiner, Sr. in Provo, UT
For this reason, disability insurance claims are highly scrutinized and often fiercely litigated.
December 18, 2019
Disability Claims Examiner, Sr. in New Bedford, MA
In addition, a Disability Examiner is experienced with determining the severity and validity of a person’s disability.
December 04, 2019