Claims Examiner jobs in Kentucky

Responsibilities: -

Review and analyze medical claims to determine coverage and eligibility - Investigate and gather information to support claim decisions - Evaluate medical records, bills, and other documentation to ensure accuracy and compliance with coding standards - Apply knowledge of medical terminology, coding systems (ICD-10, ICD-9), and billing procedures to process claims - Communicate with healthcare providers, policyholders, and other parties to gather necessary information and resolve claim issues - Make claim determinations based on policy guidelines and industry regulations - Document claim decisions and maintain accurate records

Experience: - Previous experience as a Claims Adjuster/Examiner - Knowledge of medical office procedures, including medical coding and billing - Familiarity with medical terminology, systems, and documentation - Understanding of insurance policies, coverage, and claims processes - Strong analytical skills with the ability to review and interpret complex medical records - Excellent attention to detail and accuracy in claims processing - Effective communication skills to interact with various stakeholders Note: This job description is not intended to be all-inclusive. The employee may perform other related duties as negotiated to meet the ongoing needs of the organization

Pay- $16/hr