Remote Claims Examiner - Healthcare Claims Specialist

Gosnaphop; Tulsa (OK); Remote; USD 33,000 - 44,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Company holidays

Employee assistance program

Job summary

Addison Group is seeking a Claims Examiner for a Tulsa-based client in the Insurance/Healthcare space. This Direct Hire role focuses on reviewing, evaluating, and processing healthcare claims with strict adherence to regulations.

The successful candidate will demonstrate accuracy, strong communication with providers and clients, and proficiency with claims systems. Remote work option is available, with standard Mon-Fri 8am-5pm hours.

Qualifications

• Experience with healthcare claims processing or related field.
• Ability to interpret policies, benefit information, and guidelines.
• Proficiency with standard computer applications.

Responsibilities

• Review claims to verify eligibility, docs, and coverage.
• Evaluate claims using plan provisions and guidelines.
• Determine outcomes: approvals, adjustments, or denials.
• Request or coordinate additional information as needed.
• Maintain accurate claims records and documentation.
• Communicate with providers and clients about claim status.
• Identify discrepancies and escalate issues accordingly.
• Protect HIPAA privacy and handle sensitive information.

Skills

Attention to detail

Analytical thinking

Communication skills

Time management

Education

High school diploma or equivalent

Tools

Claims processing systems

Excel

Job description

Addison Group is seeking a Claims Examiner for a Tulsa-based client in the Insurance/Healthcare space. This Direct Hire role focuses on reviewing, evaluating, and processing healthcare claims with strict adherence to regulations.

The successful candidate will demonstrate accuracy, strong communication with providers and clients, and proficiency with claims systems. Remote work option is available, with standard Mon-Fri 8am-5pm hours.