Claims Examiner & Support Specialist - Entry Level

HealthTexas; San Antonio (TX); On-site; USD 38,000 - 52,000; Full time

Job summary

HealthTexas in San Antonio, TX is seeking a detail-oriented Claims Examiner & Support Specialist Level I to process delegated health plan claims, respond to provider inquiries by phone, and perform essential administrative tasks.

The role emphasizes accuracy, adherence to guidelines, and customer service excellence in a fast-paced office setting. Strong data entry skills, familiarity with claims processing, and the ability to multi-task are valued.

Qualifications

• Must have basic knowledge of healthcare terminology and claim processing procedures.
• Experience with data entry and attention to detail is essential.
• Good written and verbal communication skills are required.
• Ability to adapt to changing guidelines and procedures.
• Typing speed of at least 50 WPM is preferred.

Responsibilities

• Process health plan delegated claims for accuracy and completeness.
• Verify information in claims aligns with established guidelines.
• Adjudicate claims according to plan policies and regulatory guidelines.
• Ensure timely and accurate processing of delegated claims.
• Answer provider inquiries via phone with prompt, accurate responses.
• Document calls and resolutions for each inquiry.
• Perform administrative tasks to support the claims processing department.
• Log disputes and track resolution status.
• Process incoming mail related to claims and distribute appropriately.
• Perform other duties as assigned by supervisors or managers.

Skills

Healthcare terminology

Claim processing

Data entry

Phone etiquette

Multitasking

Typing 50 WPM

Communication

Education

High School diploma or GED

Tools

Microsoft Office

Job description

HealthTexas in San Antonio, TX is seeking a detail-oriented Claims Examiner & Support Specialist Level I to process delegated health plan claims, respond to provider inquiries by phone, and perform essential administrative tasks.

The role emphasizes accuracy, adherence to guidelines, and customer service excellence in a fast-paced office setting. Strong data entry skills, familiarity with claims processing, and the ability to multi-task are valued.