Claims Examiner

Mondo; Rosemont (IL); Remote; USD 28,000 - 33,000; Part time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401K

Job summary

Mondo is seeking a Claims Examiner I for a 4-6 month contract that is 100% remote. The role pays $20-$24 per hour and starts around November 30, 2026.

You will review, analyze, and process medical claims to determine payment or denial, leveraging hands-on claims processing experience with HMO knowledge. The ideal candidate has 2-3 years of claims experience and familiarity with commercial, Medicare, and Medicaid health plans.

Qualifications

• Associate's degree or equivalent experience.
• 2-3 years of hands-on claims processing experience.
• Previous HMO experience.
• Experience processing medical claims.
• Knowledge of Commercial, Medicare, and Medicaid health plans.
• Strong attention to detail and accuracy.
• Excellent organizational, analytical, and communication skills.
• Proficiency in Microsoft Office and ability to learn new software systems.

Responsibilities

• Review and process medical claims to determine appropriate payment or denial.
• Verify claim accuracy, payment amounts, and required authorizations.
• Research and resolve claims with system errors or payment holds.
• Identify recurring provider and member issues and recommend solutions.
• Coordinate payments between insurance companies when applicable.
• Research and resolve claims-related questions and issues.
• Identify opportunities to improve claims processing workflows.
• Maintain accurate procedures and documentation.
• Follow HIPAA guidelines and protect confidential patient information.
• Work collaboratively with team members and management to meet department goals.

Skills

Claims processing

HMO experience

Attention to detail

Analytical skills

Communication skills

Microsoft Office

Education

Associate's degree or equivalent experience

Job description

Title: Claims Examiner I
Employment Type: Contract
Duration: 4-6 months initially
Location: 100% Remote
Pay Rate: $20-$24 per hour
Target Start Date: November 30, 2026
Benefits:Eligible for Health, Dental, Vision, 401K
Must be authorized to work in the U.S. This position is not eligible for sponsorship.

Position Overview

We are seeking a Claims Examiner I to review, analyze, and process medical claims to determine appropriate payment or denial. The ideal candidate will have hands-on claims processing experience, HMO experience, and knowledge of commercial, Medicare, and Medicaid health plans.

Key Responsibilities

• Review and process medical claims to determine appropriate payment or denial.

• Verify claim accuracy, payment amounts, and required authorizations.

• Research and resolve claims with system errors or payment holds.

• Identify recurring provider and member issues and recommend solutions.

• Coordinate payments between insurance companies when applicable.

• Research and resolve claims-related questions and issues.

• Identify opportunities to improve claims processing workflows.

• Maintain accurate procedures and documentation.

• Follow HIPAA guidelines and protect confidential patient information.

• Work collaboratively with team members and management to meet department goals.

Required Qualifications

• Associate's degree or equivalent experience.

• 2-3 years of relevant professional experience, including hands-on claims processing.

• Previous HMO experience.

• Experience processing medical claims.

• Knowledge of Commercial, Medicare, and Medicaid health plans or TPA organizations.

• Strong attention to detail and accuracy.

• Excellent organizational, analytical, and communication skills.

• Proficiency in Microsoft Office and ability to learn new software systems.

Preferred Qualifications

• Knowledge of CPT-4, HCPCS, and ICD-10 coding.

• Familiarity with medical terminology.

• Understanding of medical billing, provider networks, and contracted rates.

• Experience with claims authorizations and coordination of benefits (COB).