Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Job Summary: The Claims Examiner is detail-oriented and will be responsible for reviewing and adjudicating health insurance claims for all products and all lines of business, including but limited to Medicare, Self-Funded, Fully Insured, ensuring accuracy compliance with policies and regulations and timely settlements. This role involves assessing claims, verifying information, and communicating effectively with internal stakeholders, members, providers and their office staff and other insurance companies.
Qualifications and Requirements:
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0 Claims Clerk jobs found in Reno, NV area