Claims Examiner

Reviewing and processing insurance claims, the full-time Claims Examiner will validate member and provider information, determine payment criteria, and ensure compliance with policies while working remotely. Key responsibilities Review and process insurance claims, validating necessary information for accuracy Determine payment criteria for pending claims based on established policies and procedures Maintain productivity goals and quality standards while resolving complex situations according to guidelines Required qualifications University degree or equivalent with formal studies in English and basic Math 6+ months of experience applying business rules and making decisions in varying situations 6+ months of data entry experience with a focus on quality and accuracy 6+ months of experience using Windows PC applications and learning new software tools 6+ months of experience prioritizing workload to meet deadlines #J-18808-Ljbffr