Claims Examiner

State of Utah; Salt Lake City (UT); Hybrid; USD 45,000 - 56,000; Full time

Benefits offered by this job

Full benefits package

Job summary

The State of Utah in Salt Lake City seeks a Medicaid Claims Examiner II to provide exceptional customer service while processing medical claims in accordance with Medicaid guidelines. This full-time role blends in-office work with telework options after training, and requires handling a high volume of calls daily.

Qualifications include experience with Medicaid claims, billing practices, and strong communication skills. The position offers a full benefits package and a typical 8-5 schedule.

Qualifications

• Answer calls about Medicaid benefits, claims, billing practices, and related information.
• Adjudicate claims.
• Respond to inquiries regarding the status and correction of claims.
• Explain Medicaid billing policies, guidelines, benefits and procedures.
• May spend time in the document control area.

Responsibilities

• Provide great customer service on Medicaid-related inquiries.
• Process all types of medical claims based on Medicaid guidelines.
• Be logged into the phone system for up to 7 hours/day and handle 70–100 calls daily.
• After training, may telework up to 3 days per week with 2 in-office days.

Skills

Customer service

Medical billing

Claims adjudication

Phone support

Communication skills

Tools

Phone system

Job description

FT / PT Status – Full-Time

Benefits Eligibility – This position is eligible for a full benefits package.

Salary – $21.53 - $27.00 Hourly Wage

Remote Work / In-Office – Hybrid

Application Deadline – 10/4/2026*

Key Responsibilities

Do you enjoy providing great customer service? Do you have experience with medical billing or claims? If you answered yes to these questions the Office of Medicaid Operations with the Utah Department of Health and Human Services invites you to apply as a Medicaid Claims Examiner II.

The Medicaid Claims Examiner II position has two primary functions, to answer incoming customer service calls and to process all types of medical claims based on Medicaid guidelines. You will be required to be logged into the phone system for up to 7 hours/day and take between 70 to 100 calls a day. After training, this position may be eligible to telework from home for up to 3 days per week, with 2 in-office days.

Preference May Be Given To Applicants That Have

• Experience processing and adjusting electronic and paper claims
• Experience with medical billing or collections
• Excellent customer service skills

Supplemental Information

• This position may currently be a hybrid of both in-office and remote work days. Please note, a position's eligibility for remote work is established by agency management and is subject to change at their discretion, at any time and for any reason.
• The typical office setting for this job is adequately lighted, heated and ventilated. However, you may encounter some risks that are associated with any office setting, for example, the safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
• Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.
• Standard Schedule: Monday - Friday, 8:00 am to 5:00 pm

Qualifications

• Answer calls about Medicaid benefits, claims, billing practices, and other related information from the medical community and public.
• Adjudicate claims.
• Respond to phone, electronic, fax and mail inquiries regarding the status and correction of claims.
• Explain and interpret Medicaid billing policies, guidelines, benefits and procedures.
• May spend time in the document control area.

About The Role

Location –

288 North 1460 West

Salt Lake City, Utah, 84116

United States

Background Check Required – You must successfully pass a criminal history check.

Drug Test Required – No

Schedule Code – TL - Time limited

Why You Should Join Our Team

In Utah, we believe hard work is important, but balance is essential. Finding work/life balance is a vital element to our culture. Other benefits may include:

• Job Stability: Enjoy the security and reliability of employment within a well-established organization.
• Career Growth: Develop valuable skills and gain opportunities for leadership within a large organization.
• Meaningful Work: Contribute to an important service that benefits the community and supports organizational goals.
• Supportive Work Environment: Be part of a team that values cooperation, strong work ethics, and mutual support.

The Agency

For more information on the Division of Integrated Healthcare, please visit our website.

EEO Statement

The State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, please contact [phone].