Claims Examiner

Job Description

Job Description

Job Title: Claims Examiner Job Description

This role entails the review, investigation, evaluation, and determination of eligibility for claims. The Claims Examiner negotiates the resolution of claims in compliance with all policies and state regulatory requirements, while managing a large volume of claims.

• Ensure customers and providers are paid timely and accurately.
• Communicate effectively with internal and external customers.
• Handle customer reimbursement requests.
• Validate daily NHS wire payments and exceptions.
• Manage the reconciliation of Customer Preferred Pricing transactions.
• Assist with inquiries regarding claim status with customers.
• Analyze and validate a high level of claims data and enter it into a proprietary operating system.
• Index invoices received in the inbox and move them to the appropriate location.
• Perform filing and other administrative duties as needed.

• Minimum of 1 year of office experience in data entry, dispatching, claims, or provider relations.
• Proficiency in Microsoft Office suite.
• Experience working in a fast-paced environment.
• Strong attention to detail and organizational skills.
• Effective verbal and written communication skills.
• Ability to adapt to changing priorities and learn new processes quickly.
• GED/High School Diploma minimum.

• Self-starter with creative problem-solving skills.
• Persuasive and thorough team player.
• Experience with Salesforce CRM, invoicing, and reimbursements.

The role is within the Claims Management Department, consisting of a team of 16, including 2 Claims Supervisors and 14 Claims Examiners. Initial training lasts 2-4 weeks, with hours from Monday to Friday, 7:30am to 4pm. Post-training, employees can choose from several shifts: Monday to Friday, 7am-3:30pm, 7:30am-4pm, or 8am-4:30pm. Work from home is available on Mondays and Fridays after training. The office is located in a brand-new facility in Naperville, featuring a modern 'pit-style' environment, great energy, and a nice kitchen area with a soda machine.

This is a Contract position based out of Naperville, IL.

The pay range for this position is $20.00 - $20.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

This is a hybrid position in Naperville,IL.

This position is anticipated to close on Aug 10, 2026.

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® Platinum Award winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email View email address on ziprecruiter.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.