Claims Examiner jobs in Nevada

Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Claims Examiner
  • Universal Health Services, Inc.
  • Reno, NV FULL_TIME
  • Responsibilities

    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

    Qualifications and Requirements:

    • High school diploma or equivalent required.
    • Associate degree in healthcare administration, Business Administration, or related field preferred.
    • Two years' experience as a Health Insurance Claims Examiner or similar role in the insurance industry preferred.
    • In-depth knowledge of medical terminology, coding systems (ICD-10, CPT, HCPCS), and healthcare billing procedures.
    • Familiarity with health insurance policies, regulations, and compliance standards.
    • Strong analytical skills with attention to detail and accuracy in claims processing.
    • Excellent communication and interpersonal abilities to interact effectively with customers and stakeholders.
    • Proficiency in using computer systems, including claims processing software and Microsoft Office Suite.
    • Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
    • Certification in Health Insurance Portability and Accountability Act (HIPAA) compliance is a plus.
    • Strong commitment to confidentiality and ethical conduct in handling sensitive healthcare data.

    EEO Statement

    All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

    We believe that diversity and inclusion among our teammates is critical to our success.

    Notice

    At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: or 1-800-852-3449.

     

  • 19 Days Ago

U
Claims Examiner
  • UHS
  • RENO, NV FULL_TIME
  • Responsibilities 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, includin...
  • 1 Month Ago

A
Examiner
  • AXA Group
  • North Las Vegas, NV FULL_TIME
  • It’s an exciting time to join AXA Health, with investment planned in all UK&I businesses to transform, deliver new digital services to our customers and streamline and automate our business processes....
  • Just Posted

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NV - Las Vegas - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Las Vegas, NV FULL_TIME
  • 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA with offices in California, Arizona, Oregon, Nevada, Washington, Utah,...
  • 2 Days Ago

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MEDICAL EXAMINER
  • Clark County
  • Las Vegas, NV FULL_TIME
  • The Clark County Office of the Coroner/Medical Examiner is seeking to fill the Medical Examiner/Forensic Pathologist position. This office serves Clark County, Nevada, which includes Las Vegas and sur...
  • Just Posted

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Title Examiner
  • Nevada Real Estate Group
  • Reno, NV FULL_TIME
  • We are seeking an experienced title agent to join our growing team. We’re a tight-knit group of professionals that consistently provide top quality closing services to our clients. Applicants should b...
  • 9 Days Ago

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Claims Examiner
  • Berkley
  • Jersey City, NJ
  • Company Details: W. R. Berkley Corporation, founded in 1967, is one of the nations premier commercial lines property cas...
  • 4/26/2024 12:00:00 AM

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Claims Examiner
  • JT2 Integrated Resources
  • Oakland, CA
  • JT2 has over two decades of experience in claims administration and has delivered consistent cost savings to clients whi...
  • 4/26/2024 12:00:00 AM

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Claim Examiner
  • Kansas City Life Insurance Company
  • Kansas City, MO
  • QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in business field, related field, or equivalent work ex...
  • 4/26/2024 12:00:00 AM

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Claim Examiner
  • Kansas City Life Insurance Company
  • Kansas City, MO
  • QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in business field, related field, or equivalent work ex...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • Chicago, IL
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • New York, NY
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • The Jonus Group
  • Phoenix, AZ
  • We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
  • 4/22/2024 12:00:00 AM

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Claims Examiner
  • D3 Search
  • Mount Kisco, NY
  • D3 Search is actively seeking the following Claims Examiner II - Cyber candidate for a highly respected global insurer w...
  • 4/22/2024 12:00:00 AM

Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin. Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,055 to $63,723