Medical Claims Examiner

IMG (International Medical Group); United Kingdom; Remote; GBP 25,000 - 35,000; Full time

Job summary

A global medical insurance company is seeking a Claims Examiner. In this entry-level role, you will review claims for validity, resolve various types of claims, and ensure compliance with regulations. The position offers remote work flexibility and a comprehensive benefits package including medical, dental, and 401k plans.

Benefits

Quarterly performance bonus

Flexible work schedule

Comprehensive benefits package including Medical/RX/Dental/Vision insurance

401k Plan with company match

Paid Time Off

Free employee parking

Tuition reimbursement plan

Qualifications

• Minimum 1 year of prior medical claims processing experience or related experience.
• High attention to detail with ability to analyze information.
• Proficiency with basic math.

Responsibilities

• Review claims to determine validity of insurance claims.
• Resolve medical/dental/life/trip cancellation claims.
• Ensure compliance with company policies and regulations.

Skills

Medical claims processing experience

Knowledge of basic medical terminology

Attention to detail

Problem-solving skills

Education

At least 1 year of experience in medical claims processing or related field

Job description

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of all sizes. Every second of every day, vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence use our products to give themselves global peace of mind

We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for travelers.

JOB DETAILS

• Remote & Hybrid work schedules available.
• Flexible Scheduling after completion of training and criteria requirements are met*
• Bonus Opportunities: Quarterly performance bonus plan if qualifications are met*
• Relocation Expenses Reimbursed: No
• Qualified candidates must be legally authorized to be employed in the United States. IMG will not be providing sponsorship for employment visa status (e.g., H-1B or TN status) for this position.
  
  
  

Job Summary

Claims Examiners provide a service to our policyholders by reviewing claims to determine the validity of the insurance claim filed and identify the need for further investigations. Examiners resolve medical/dental/life/trip cancellation claims; documenting actions; maintaining their imaging queues; maintaining quality audit standards and ensuring their outcomes are following the Certificate of Insurance, Policy and Plan Documents as well as legal and regulatory agencies.

Duties And Responsibilities

• Determines covered insurance losses by studying provisions of policy or certificate.
• Establishes proof of loss by studying proof of claim; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
• Documents medical claims actions by completing forms, reports, logs, and records.
• Resolves claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
• Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
• Maintains quality customer services by following core values.
  
  
  

Qualifications

• At least 1 year of prior medical claims processing experience OR willing to consider at least 2 years of experience with coding, billing, reviewing medical records, claims research, benefits review, medical office, or any other claims related role (i.e. complex claims, LCM claims, BI claims, P&C claims, etc.)
• Knowledge of basic medical terminology
• Ability to read and interpret insurance policy/certificate wording
• Ability to research and logically consider details from multiple sources to analyze and make a determination of benefits within a productivity-based environment
• Computer skills and proficiency in operating common office equipment
• Documentation, Data Entry Skills
• High attention to detail with ability to analyze information and Problem-solving skills
• Proficiency with basic math
  
  
  

Preferred Skills

• Knowledge of ICD-10
• Knowledge of FDA Health and HIPAA Regulations
  
  
  

PERKS

• Quarterly performance bonus (*must meet department standards and qualifications)
• Flexible work schedule
• Comprehensive benefits package including Medical/RX/Dental/Vision insurance
• 401k Plan with company match
• Paid Time Off
• Free employee parking
• Tuition reimbursement plan
  
  
  

IMG is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, ethnicity, national origin, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, and other protected statuses as required by applicable law.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Insurance

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