Claims Examiner jobs in Oklahoma
Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Examiner jobs
Claims HMO - Claims Examiner 140-1018
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. KEY RESPONSIBILITIES: Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in determining appropriate actions. Identify claims requiring additional resources and route to the team lead, supervisor or other departments as needed. Enter claims information using the processing software to compute payments, allowable amounts, limitations, exclusions and denials. Identify and communicate trends or problems identified during adjudication process. Contribute to the creation of a pleasant working environment with peers and other departments. Assist in investigating and solving claims that require additional research. Consistently learn and adapt to changes related to claims processing, benefits, limits and regulations. Perform other duties as assigned. QUALIFICATIONS: Self-motivated and able to work with minimal direction. Ability to read and understand claims processing manuals, medical terminology, CPT codes, and perform basic processing procedures. Ability to read and understand health benefit booklets. Demonstrated learning agility. Successful completion of Health Care Sanctions background check. Knowledge in the contracted managed care plan terms and rates. General understanding of unbundling methods, COB, and other over-billing methodologies. Must have high attention to detail. Proficient in Microsoft applications. Ability to perform basic mathematical calculations. Possess strong oral and written communication skills. EDUCATION/EXPERIENCE: High School Diploma or Equivalent required. Two years related work experience in claims processing, claims data entry or medical billing OR medical related education to meet minimum two years required.
- 8 Days Ago
Medical Claims Examiner
- The Kempton Group Administrators
-
Oklahoma, OK
FULL_TIME
- Job DescriptionMedical Claims ExaminerAt The Kempton Group, we are changing the healthcare industry. We believe in transparency and we have the genuine desire to transform how employers and participan...
- 6 Days Ago
Claims HMO - Senior Claims Examiner 140-1047
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: The Senior Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen ...
- 23 Days Ago
Accountant I
- Claims Management Resources Inc
-
Oklahoma, OK
FULL_TIME
- Who We Are We are in the business of subrogation – companies trust us to recover payments on damage claims so that the party responsible is the one paying for the damage that was caused. We strive to ...
- 2 Days Ago
Data Entry Specialist
- CLAIMS MANAGEMENT RESOURCES INC
-
Oklahoma, OK
OTHER
- Job Details Level: Entry Job Location: OKC Office - Oklahoma City, OK Position Type: Full Time Education Level: High School Salary Range: $12.00 - $14.00 Hourly Travel Percentage: None Job Shift: Day ...
- 4 Days Ago
Human Resources Coordinator
- CLAIMS MANAGEMENT RESOURCES INC
-
Oklahoma, OK
OTHER
- Job Details Level: Experienced Job Location: OKC Office - Oklahoma City, OK Position Type: Full Time Education Level: 2 Year Degree Salary Range: $18.00 - $21.00 Hourly Travel Percentage: None Job Shi...
- 4 Days Ago
Claims Examiner jobs at Popular Companies
Claims Examiner
- US Tech Solutions, Inc.
-
Atlanta, GA
- Job Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: Responsibilities: • Inve...
- 6/11/2024 12:00:00 AM
Claims Examiner
- Manpower
-
El Segundo, CA
- Our client, Legal Industry is seeking a Claims Examiner to join their team. As a Legal Claims Examiner you will be part ...
- 6/11/2024 12:00:00 AM
Claims Examiner
- Insight Global
-
Folsom, CA
- Insight Global is looking for a Claims Examiner for one of their insurance clients in Folsom, CA. This is a fully onsite...
- 6/10/2024 12:00:00 AM
Claims Examiner
- Insight Global
-
Folsom, CA
- The Claims Examiner is responsible for ensuring claims are coded and processed correctly and for meeting production requ...
- 6/10/2024 12:00:00 AM
Claims Examiner
- Capital Blue Cross
-
Harrisburg, PA
- Position Description: This position is responsible for the coding and total processing of claims and triaging claim adju...
- 6/9/2024 12:00:00 AM
Claims Examiner
- The Jonus Group
-
- Position Overview: As a Commercial Auto and General Liability Claims Adjuster, you will be responsible for managing comp...
- 6/8/2024 12:00:00 AM
Claims Examiner
- AIG
-
Cincinnati, OH
- This is a hybrid role in Cincinnati Ohio requiring 3 to 4 days in office. Who we are American International Group, Inc. ...
- 6/8/2024 12:00:00 AM
Claims Examiner
- JCW
-
- JCW is currently recruiting on behalf of a rapidly growing Property & Casualty Insurance Company who are looking to add ...
- 6/7/2024 12:00:00 AM
About Oklahoma
Oklahoma is the 20th-largest state in the United States, covering an area of 69,899 square miles (181,040 km2), with 68,595 square miles (177,660 km2) of land and 1,304 square miles (3,380 km2) of water. It lies partly in the Great Plains near the geographical center of the 48 contiguous states. It is bounded on the east by Arkansas and Missouri, on the north by Kansas, on the northwest by Colorado, on the far west by New Mexico, and on the south and near-west by Texas. Much of its border with Texas lies along the Southern Oklahoma Aulacogen, a failed continental rift. The geologic figure defi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$44,495 to $59,003