Claims Examiner

Vaco is partnering with a growing organization to hire a Claims Examiner. This role is ideal for a detail-oriented professional with experience in claims processing, claims adjudication, and regulatory compliance. The selected candidate will review and process claims, ensure accurate benefit determinations, identify billing discrepancies, and support payment integrity initiatives. This position also partners with internal teams to resolve claim issues, support appeals, and contribute to process improvements. If you're looking to join a collaborative organization focused on accuracy and operational excellence, apply today! Qualifications Bachelor's degree in Business, Healthcare Administration, or a related field preferred; equivalent work experience considered 2+ years of claims processing or claims examination experience Experience reviewing, analyzing, and adjudicating claims in accordance with plan benefits, policies, and applicable guidelines Knowledge of claims processing, billing, reimbursement practices, and electronic claims transactions Experience identifying billing discrepancies, payment errors, and potential fraud, waste, and abuse Ability to investigate claim issues, determine appropriate claim outcomes, and resolve discrepancies efficiently Experience handling claim appeals, adjustments, and reprocessing activities Strong understanding of regulatory and compliance requirements Proficiency with claims processing systems and Microsoft Office Suite Excellent analytical, organizational, and problem-solving skills with exceptional attention to detail Strong verbal and written communication skills with the ability to collaborate across cross‑functional teams Ability to manage multiple priorities and work effectively in a fast‑paced, high-volume environment Professional coding, claims, or reimbursement certifications are a plus Benefits Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual's skill sets, experience and training, licensure and certifications, office location and other geographical considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company's 401(k) retirement plan. Equal Opportunity Notice Highspring LLC (d/b/a Vaco by Highspring) and its parents, affiliates, and subsidiaries ("we," "our," or "Vaco by Highspring") are committed to the full inclusion of all qualified individuals and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by applicable law. The company is also committed to ensuring that persons who need them are provided with reasonable accommodations; if an accommodation is needed to participate in the job application or interview process, please contact View email address on click.appcast.io. Pay Transparency Notice Salary determination factors include: the individual's skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; and other business and organizational needs. The individual may also be eligible for discretionary bonuses and/or participation in medical, dental, and vision benefits as well as the company's retirement plan. #J-18808-Ljbffr