Claims Examiner

Healthcare Support Staffing; Annapolis (MD); On-site; USD 22,730 - 32,373; Full time

Job summary

Healthcare Support Staffing is seeking an experienced Claims Examiner in Annapolis, Maryland. In this role, you will review provider disputes and appeals related to claims resolution, adhering to both state and federal policies.

The ideal candidate will have at least 1 year of experience in managing disputes in a PPO or HMO setting and possess a strong understanding of medical terminology. The position offers a shift from Monday to Friday, 8am to 5pm, with a pay rate of up to $20/hour.

Qualifications

• Must have at least 1 year of experience in handling provider disputes and appeals.
• Ability to understand medical terminology is essential.

Responsibilities

• Review providers’ disputes and appeals for claims resolution.
• Adhere to state and federal policies when adjudicating claims.
• Perform projects as delegated by claims supervisor.

Skills

Handling provider disputes

Understanding of Medical Terminology

Education

High School Diploma or GED

Job description

Job Description

Are you an experienced Claims Examiner looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Essential Functions

• Reviews providers’ disputes and appeals for professional and hospital claims to determine resolution according to policies and procedures.
• Adheres to state and federal policies and procedures when adjudicating claims, including but not limited to, interest calculation and resolution timeliness.
• Perform any projects delegated by claims supervisor.

Qualifications

• High School Diploma or GED
• 1+ year experience handling provider disputes / appeals, preferably in PPO, Self-Funded and/or HMO setting.
• Understanding of Medical Terminology.

Additional Information

• Shift: M-F 8am-5pm
• RTH or Temp-To-Perm (Any transition heavily depends on performance)
• Pay Rate: Up to 20/hour