Claims Examiner


BASIC FUNCTION:

- Research and make benefit determinations for the processing or medical and hospital claims according to contractual and processing guidelines.
- Identify and communicate claims processing, procedural and training issues to Supervisor.
- Maintain production and quality in accordance with the departmental standards.
- Organize and handle individual workload to ensure that all new work and 'pend' claims are processed on a "first in/first out" basis.
- Exhibit professionalism and perform in a manner that supports the company's emphasis on customer service and operational excellence.




Back to Work Enviroment


 

 

We are a serious company working to become a leader in the transformation of the healthcare industry and to make a difference in the communities in which we serve. However, that does not mean we don't enjoy being at the workplace and having fun along the way! In fact we state in writing:

 

We work hard, we play hard,

we reward results well.