Claims Examiner, Sr. jobs in Oklahoma
Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. 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, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Examiner, Sr. jobs
Claims HMO - Claims Examiner 140-1025
- CommunityCare
-
Tulsa, OK
FULL_TIME
- JOB SUMMARY: The Claims Examiner is responsible for examining claims that require review prior to being adjudicated. The examiner will use their resources, knowledge and decision-making acumen to determine the appropriate actions to pay, deny or adjust the claim. Examiners are expected to meet performance expectations in accuracy and efficiency. KEY RESPONSIBILITIES: Examining and adjudicating claims that have pended for review utilizing resources, tools, knowledge and decision-making in determining appropriate actions. Identify claims requiring additional resources and route to the team lead, supervisor or other departments as needed. Enter claims information using the processing software to compute payments, allowable amounts, limitations, exclusions and denials. Identify and communicate trends or problems identified during adjudication process. Contribute to the creation of a pleasant working environment with peers and other departments. Assist in investigating and solving claims that require additional research. Consistently learn and adapt to changes related to claims processing, benefits, limits and regulations. Perform other duties as assigned. QUALIFICATIONS: Self-motivated and able to work with minimal direction. Ability to read and understand claims processing manuals, medical terminology, CPT codes, and perform basic processing procedures. Ability to read and understand health benefit booklets. Demonstrated learning agility. Successful completion of Health Care Sanctions background check. Knowledge in the contracted managed care plan terms and rates. General understanding of unbundling methods, COB, and other over-billing methodologies. Must have high attention to detail. Proficient in Microsoft applications. Ability to perform basic mathematical calculations. Possess strong oral and written communication skills. EDUCATION/EXPERIENCE: High School Diploma or Equivalent required. Two years related work experience in claims processing, claims data entry or medical billing OR medical related education to meet minimum two years required.
- 11 Days Ago
Claims Service Representative
- Claims Management Resources Inc
-
Oklahoma, OK
FULL_TIME
- Are you looking for a company where you can learn, grow, and advance your career? At Claims Management Resources, we believe in putting our employees first. Come join our team and be part of a fast-gr...
- 7 Days Ago
Claims Service Representative
- CLAIMS MANAGEMENT RESOURCES INC
-
Oklahoma, OK
OTHER
- Job Details Level: Experienced Job Location: OKC Office - Oklahoma City, OK Position Type: Full Time Education Level: High School Salary Range: $14.00 - $14.00 Hourly Travel Percentage: None Job Shift...
- 9 Days Ago
Entry Level Claims Adjuster - Work from home!
- Claims Management Resources Inc
-
Oklahoma, OK
FULL_TIME
- Are you interested in working for a company that not only “talks the talk” but “walks the walk”?Lucrative Compensation Plan! Base of $15.00 per hour, PLUS monthly bonus!NO INSURANCE ADJUSTING EXPERIEN...
- 4 Days Ago
Entry Level Claims Adjuster - Work from home!
- CLAIMS MANAGEMENT RESOURCES INC
-
Oklahoma, OK
OTHER
- Job Details Level: Entry Job Location: Remote - Oklahoma City, OK Position Type: Full Time Education Level: High School Salary Range: $15.00 - $12.00 Base Commission/month Travel Percentage: None Job ...
- 5 Days Ago
Aerie - Sr Brand Ambassador (Sr Sales Associate) - US
- Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
-
United States, OK
FULL_TIME
- BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
- Just Posted
Claims Examiner, Sr. jobs at Popular Companies
Claims Examiner
- Experis
-
Pasadena, CA
- Job Title: Workers Compensation Claims Examiner 6 month Contract $45hr Location: Onsite preferred, Remote (within CA) or...
- 5/10/2024 12:00:00 AM
SIU / Claims Investigator
- Allied Universal Compliance and Investigations
-
Bossier City, LA
- Job Description Job Description Overview Allied Universal Compliance and Investigations, North America's leading expert ...
- 5/9/2024 12:00:00 AM
SIU / Claims Investigator
- Allied Universal
-
Chattanooga, TN
- Overview: Allied Universal Compliance and Investigations, North Americas leading expert insurance claim investigations, ...
- 5/9/2024 12:00:00 AM
Tort Claims Investigator 1>
- Washington State Government
-
Olympia, WA
- Washington State Government - JobID: 4493220 [Detective] As an Investigator at the State of Washington, you'll: Conduct ...
- 5/9/2024 12:00:00 AM
Intern - Social Media Claims Investigation
- SECURA Insurance
-
Neenah, WI
- This intern position supports our Special Investigation Unit by gathering information from various social sites such as ...
- 5/8/2024 12:00:00 AM
Claims Investigator
- Daniel J. Hannon and Associates, Inc.
-
Forest Hills, NY
- Job Description Job Description Company Info: Daniel J. Hannon & Associates, Inc. (DJH) is a Long Island-based insurance...
- 5/7/2024 12:00:00 AM
Claims Investigator
- Daniel J. Hannon and Associates, Inc.
-
Buffalo, NY
- Job Description Job Description Company Info: Daniel J. Hannon & Associates, Inc. (DJH) is a Long Island-based insurance...
- 5/7/2024 12:00:00 AM
SIU / Claims Investigator
- Allied Universal
-
Tallulah, LA
- Overview: Allied Universal Compliance and Investigations, North Americas leading expert insurance claim investigations, ...
- 5/7/2024 12:00:00 AM
About Oklahoma
Oklahoma is the 20th-largest state in the United States, covering an area of 69,899 square miles (181,040 km2), with 68,595 square miles (177,660 km2) of land and 1,304 square miles (3,380 km2) of water. It lies partly in the Great Plains near the geographical center of the 48 contiguous states. It is bounded on the east by Arkansas and Missouri, on the north by Kansas, on the northwest by Colorado, on the far west by New Mexico, and on the south and near-west by Texas. Much of its border with Texas lies along the Southern Oklahoma Aulacogen, a failed continental rift. The geologic figure defi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$57,765 to $74,478
Most Popular Cities in Oklahoma for Claims Examiner, Sr. Jobs
What does a Claims Examiner, Sr. do?
Claims Examiner, Sr. in Sarasota, FL
After reading this, you will have a much better idea on whether you will like working as a Property and Casualty Insurance Claims Examiner or not.
January 17, 2020
Claims Examiner, Sr. in Fairbanks, AK
Still, a good number of students health claims specialist resume have to contend with language skill barriers.
February 05, 2020
Claims Examiner, Sr. in Idaho Falls, ID
Kevin Pitts joined CIRSA a little over a year ago as a Workers’ Compensation Claims Examiner.
December 18, 2019