Claims Examiner I

Claim Examiner PositionBlue Cross of Idaho is seeking a Claim Examiner to review and adjudicate paper/electronic claims. Determine whether to return, deny or pay claims following organizational policies and procedures.Required Experience1-year relevant experienceDaily ResponsibilitiesReview claim and determine denial, acceptance or a need for further investigation.Recognize and reports issues and escalates, as necessary.Review existing claims for errors and omissions.Interpret and applies all business rules, policies and contract.Additional RequirementsKnowledge of medical terminologyAbility to complete assigned individual tasks within scopeResearch and navigate web-based programsWork with detailed-oriented materialFollow detailed workflow and instructionsVerbal & Written CommunicationAs of the date of this posting, a good faith estimate of the current pay range is $19.45 - $27.23. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.Reasonable AccommodationsTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.