Claims Examiner jobs in Reno, NV

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.

     

  • 17 Days Ago

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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

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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...
  • 7 Days Ago

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Mobile Phlebotomist/Paramedical Examiner
  • ExamOne, a Quest Diagnostics company
  • Reno, NV PART_TIME
  • Medically trained Mobile Collector:As a Mobile Collector, you would be a part-time, on-call, and at-will employee.What does this mean?On-Call and At-Will equal Flexibility! You will choose the days an...
  • 1 Month Ago

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Supervisor, Claims
  • UHS
  • RENO, NV FULL_TIME
  • Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Pr...
  • 23 Days Ago

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Mobile Phlebotomist/Paramedical Examiner (NV)
  • ExamOne, A Quest Diagnostics Company
  • Reno, NV PART_TIME
  • Medically trained Mobile Collector:As a Mobile Collector, you would be a part-time, on-call, and at-will employee. What does this mean?On-Call and At-Will equal Flexibility! You will choose the days a...
  • 7 Days Ago

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0 Claims Examiner jobs found in Reno, NV area

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Client Relationship Manager
  • Ernest
  • Reno, NV
  • Ernest is currently in search of a Client Relationship Manager (outside B2B sales) for our division located in Reno, NV....
  • 4/24/2024 12:00:00 AM

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Client Relationship Manager
  • Ernest
  • Sparks, NV
  • Ernest is currently in search of a Client Relationship Manager (outside B2B sales) for our division located in Sparks an...
  • 4/23/2024 12:00:00 AM

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Insurance Agent (Sales, Customer Service)
  • Freeway Insurance Services America LLC
  • Carson City, NV
  • Sign-On Bonus Opportunity of up to $3,500* Pay Range: $50000 - $80000 / year Our Perks: Unlimited/Uncapped commission Lu...
  • 4/23/2024 12:00:00 AM

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Remote Medicare Benefits Consultant - License Required
  • Assurance
  • Carson City, NV
  • Buying insurance can be complicated. Assurance is out to change that, leveraging data science to guide recommendations. ...
  • 4/23/2024 12:00:00 AM

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Outside Sales Representative
  • Ernest
  • Reno, NV
  • Ernest is currently in search of a Client Relationship Manager (Outside B2B Sales Rep) for our division located in Reno,...
  • 4/23/2024 12:00:00 AM

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Medicare Sales Agent
  • GoHealth
  • Reno, NV
  • * In order to be considered, applicants must have an active Health Insurance license. Work remotely from your home. Set ...
  • 4/22/2024 12:00:00 AM

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Sales VP’s, National Account Manager, and / or Regional Sales Managers
  • GHA Technologies, Inc
  • Reno, NV
  • Financial Highlights – Enjoy an Immediate Pay Raise! $2,500 First Week Training Pay for the first five training days. $5...
  • 4/21/2024 12:00:00 AM

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Branch Office Administrator
  • Edward Jones
  • Reno, NV
  • Would you call yourself a relationship builder, a problem solver or a critical thinker? If you answered yes, we need you...
  • 4/5/2024 12:00:00 AM

Reno (/ˈriːnoʊ/ REE-noh) is a city in the U.S. state of Nevada, located in the northwestern part of the state, approximately 22 miles (35 km) from Lake Tahoe. Known as "The Biggest Little City in the World", Reno is known for its casino industry. It is the county seat of Washoe County. The city sits in a high desert at the foot of the Sierra Nevada and its downtown area (along with Sparks) occupies a valley informally known as the Truckee Meadows. The city is named after Union Major General Jesse L. Reno, who was killed in action at the Battle of South Mountain on Fox's Gap. Reno, with an esti...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,103 to $63,786
Reno, Nevada area prices
were up 2.5% from a year ago