Claims Examiner

Detail-oriented and experienced in claims processing, the temporary Claims Examiner will work remotely to process hospital and medical claims for self-funded and level-funded groups, determining payable amounts and ensuring accuracy for timely payments. Key responsibilities: Process hospital and medical claims according to plan rules for self-funded and level-funded groups Determine payable amounts, deductibles, co-pays, and co-insurance limits based on fee schedules and insurance plans Identify billing discrepancies and coordinate necessary corrections with providers and internal teams Required qualifications: Experience in claims processing for self-funded and level-funded groups Proficiency with CRM, Beacon Claims Administrative System, and Microsoft Office tools Ability to manage multiple priorities and adapt to new systems quickly Strong communication skills and sound judgment Attention to detail and efficiency in a fast-paced environment