Fully Remote Claims Examiner I (Medical/WC)

TRISTAR Company; Corpus Christi (TX); Teletrabalho; USD 28 000 - 40 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k)

Paid Holidays

Paid Time Off

Referral Bonus

Resumo da oferta

TRISTAR Company in Corpus Christi, TX seeks an experienced Claims Examiner I to manage medical-only and workers' compensation claims under supervision. You will interact with claimants, providers, and clients, and ensure timely processing in accordance with state law and company guidelines.

The role requires attention to detail, the ability to work with multiple stakeholders, and commitment to accuracy in documentation and reserve setting.

Qualificações

• Minimum of one year of related medical claims experience.
• Knowledge of statutory regulations and medical terminology.
• Strong written and verbal communication skills.
• Ability to interact with clients and staff at all levels.

Responsabilidades

• Manages 150 to 180 workers’ compensation files.
• Initiates investigations and determines compensability.
• Manages medical treatment and billing.
• Communicates with claimants, providers, and vendors.
• Maintains diary system and timely updates.
• Preserves reserves within guidelines.
• Adheres to company policies.

Conhecimentos

Medical claims handling

Analytical skills

Excellent communication

Word & Excel

Ferramentas

Microsoft Word

Microsoft Excel

Descrição da oferta de emprego

TRISTAR Company in Corpus Christi, TX seeks an experienced Claims Examiner I to manage medical-only and workers' compensation claims under supervision. You will interact with claimants, providers, and clients, and ensure timely processing in accordance with state law and company guidelines.

The role requires attention to detail, the ability to work with multiple stakeholders, and commitment to accuracy in documentation and reserve setting.