Claims Examiner

Firstsource Solutions Limited; United States; Remoto; USD 28.000 - 39.000; Tempo pieno

Descrizione del lavoro

Firstsource Solutions Limited seeks a detail-oriented Claims Examiner for our Dallas area role with remote work after training. You will review claims, verify documentation, and ensure policy compliance while communicating with claimants, providers, and internal teams to move cases forward efficiently.

The ideal candidate has 1–2 years in claims examination, strong attention to detail, and fluency in English and Spanish.

Competenze

• 1-2 years of experience in claims examination or related role.
• Strong knowledge of claims processing and policy guidelines.
• Bilingual English/Spanish is required or preferred.

Mansioni

• Review and analyze claims submissions for eligibility and policy compliance.
• Investigate discrepancies in claims documentation and verify information.
• Communicate with claimants, providers, and teams to facilitate claims processing.
• Maintain accurate records of claims activities per company policies.
• Identify patterns to suggest process improvements and efficiency gains.
• Provide training to junior staff on claims processing practices.
• Stay updated on industry regulations and changes in processing standards.
• Assist in developing and implementing claims policies and procedures.

Conoscenze

Claims processing

Claims software

Attention to detail

Communication

Bilingual English/Spanish

Independent work

Production quality standards

Formazione

Experience in claims examination

Strumenti

Claims management software

Descrizione del lavoro

Job Title: Claims Examiner

Location: Dallas, Remote (Volume)

Job Summary

We are seeking a detail-oriented and experienced Claims Examiner to join our dynamic

team. The ideal candidate will possess strong claims knowledge and a proven track record

in claims processing and analysis. This role is critical in ensuring the accuracy and

efficiency of claims handling, contributing to our commitment to exceptional service

delivery. Matrix pay per claim after training.

Responsibilities

• Review and analyze claims submissions to determine eligibility and compliance with policy guidelines.
• Investigate and resolve discrepancies in claims documentation, ensuring all necessary information is collected and verified.
• Communicate effectively with claimants, providers, and internal teams to facilitate the claims process.
• Maintain accurate records of claims activities and decisions in accordance with company policies and regulatory requirements.
• Identify trends and patterns in claims data to recommend process improvements and enhance operational efficiency.
• Provide training and mentorship to junior staff on claims processing and best practices.
• Stay updated on industry regulations and changes in claims processing standards.
• Assist in the development and implementation of claims policies and procedures.

Mandatory Skills

• Strong knowledge of claims processing, including understanding of various types of claims (e.g., health, auto, property).
• Proficient in claims management software and tools.
• Strong attention to detail and accuracy in documentation.
• Effective communication skills, both verbal and written.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Bilingual- English/Spanish
• Able to work in a fast-paced environment
• Maintaining production and quality standards

Preferred Skills

• Familiarity with regulatory compliance related to claims processing.
• Knowledge of data analysis tools and techniques.

Qualifications

• Minimum of 1-2 years of experience in claims examination or a related role.

If you are a motivated professional with a strong background in claims and a passion for