Claims Examiner jobs in Sparks, 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.

     

  • 11 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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NV - Reno - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Reno, 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 Months 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...
  • 1 Day 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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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...
  • 1 Day Ago

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0 Claims Examiner jobs found in Sparks, NV area

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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...
  • 4/18/2024 12:00:00 AM

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Licensed Life Insurance Agent
  • Pappas Agency
  • Reno, NV
  • Join Our Winning Team - Sales Agent Position with the Pappas Agency Are you looking for a rewarding career with high ear...
  • 4/17/2024 12:00:00 AM

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Customer Service Sales Representative - Remote!
  • Hughes Insurance LLC
  • Reno, NV
  • Job Description Job Description Are YOU tired of not getting paid what YOU’RE Worth? Do YOU want control of YOUR Income?...
  • 4/17/2024 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...
  • 4/16/2024 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,...
  • 4/16/2024 12:00:00 AM

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Licensed Property & Casualty Insurance Agent (Remote) – (English or Bilingual Spanish)
  • Concentrix
  • Carson City, NV
  • Job Title: Licensed Property & Casualty Insurance Agent (Remote) (English or Bilingual Spanish) Job Description ****Must...
  • 4/15/2024 12:00:00 AM

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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....
  • 4/14/2024 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

Sparks is a city in Washoe County, Nevada, United States. It was founded in 1904 and incorporated on March 15, 1905, and is located just east of Reno. The 2010 U.S. Census Bureau population count was 90,264. It is the fifth most populous city in Nevada. It is named after the late Nevada Governor John Sparks, a member of the Silver Party. Sparks is located within the Reno–Sparks metropolitan area....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,103 to $63,786
Sparks, Nevada area prices
were up 2.5% from a year ago