Claims Examiner

Detail-oriented and experienced, the Claims Examiner will process hospital and medical claims for self-funded and level-funded groups remotely, ensuring accuracy and adherence to policy rules in a temp-to-hire position. Key responsibilities: Process hospital and medical claims, determining payable amounts, deductibles, co-pays, and co-insurance limits Review, adjust, and process claims to ensure accuracy and compliance with policy Collaborate with internal teams to resolve complex claims issues and address billing discrepancies Required qualifications: Experience in claims processing for self-funded and level-funded groups Ability to manage multiple priorities and thrive in a fast-paced environment Familiarity with CRM, Beacon Claims Administrative System, and Microsoft Office tools Strong communication skills and sound judgment Detail-oriented with the ability to identify trends and opportunities for improvement