Claims Examiner, Sr. jobs in Sparks, NV

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)

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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, 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: https://uhs.alertline.com or 1-800-852-3449.

  • 15 Days Ago

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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, includin...
  • 1 Month Ago

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Sr Insurance and Claims Specialist
  • Renown Health
  • Reno, NV FULL_TIME
  • Position Purpose The Senior Insurance and Claims Specialist is responsible for compliant billing, account follow up and system operations to ensure timely and accurate claim submission and prevention ...
  • 11 Days 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,...
  • 1 Month Ago

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Project Manager (Construction)
  • SR Construction, Inc.
  • Reno, NV FULL_TIME
  • Are you an analytical thinker who loves to solve tangible problems? Are you great at seeing big picture objectives and instinctually knowing the fastest route to get there? Do people who talk too much...
  • 24 Days Ago

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Construction Superintendent
  • SR Construction, Inc.
  • Reno, NV FULL_TIME
  • Are you an analytical, fact-based, no-nonsense problem solver?Are you great at seeing big picture objectives and instinctually knowing the fastest route to get there?Are you quality-driven, but outcom...
  • 11 Days Ago

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0 Claims Examiner, Sr. jobs found in Sparks, NV area

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Compliance Specialist - RN
  • State of Nevada
  • Genoa, NV
  • The Position Under direction, the Compliance Specialist - Registered Nurse provides medical expertise for the Division o...
  • 3/28/2024 12:00:00 AM

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Physician - Emergency Medicine
  • Department of Veterans Affairs
  • Reno, NV
  • Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement ...
  • 3/28/2024 12:00:00 AM

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Bilingual Call Center Representative
  • Ascensus
  • Reno, NV
  • Ascensus is the largest independent retirement and college savings services provider in the United States, helping milli...
  • 3/27/2024 12:00:00 AM

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AIRCRAFT MECHANIC
  • Air National Guard Units
  • Reno, NV
  • Summary This position is for a AIRCRAFT MECHANIC, PD# D1366000, part of the Nevada Air National Guard. This position is ...
  • 3/27/2024 12:00:00 AM

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Revenue Project Coordinator - Coordination of Benefits
  • UHS
  • Reno, NV
  • Responsibilities Job Summary: The Revenue Project Coordinator -Coordination of Benefits (COB) will focus on Medicare Sec...
  • 3/26/2024 12:00:00 AM

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Private Investigator
  • Delta Group
  • Reno, NV
  • Job Description Job Description Salary: $18 - $35 an hour DOE Delta Group is a privately held, woman-owned, national inv...
  • 3/25/2024 12:00:00 AM

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Remote Claims Auditor II
  • National General Insurance
  • Carson City, NV
  • Job Description National General Insurance is recruiting for a Remote Claims Auditor . The ideal candidate should have a...
  • 3/25/2024 12:00:00 AM

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MEDIUM EQUIPMENT OPERATOR (INCLINE VILLAGE)
  • Washoe County, NV
  • Reno, NV
  • Salary: $55,265.60 - $71,843.20 Annually Location : Incline Village, NV Job Type: Full Time Job Number: 60018450 (02/202...
  • 3/25/2024 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, Sr. jobs
$62,699 to $80,835
Sparks, Nevada area prices
were up 2.5% from a year ago

Claims Examiner, Sr. in Riverside, CA
Health Claims Examiners, or Health Information Technicians, enter data electronically to process transactions.
December 14, 2019
Claims Examiner, Sr. in Evansville, IN
If you’re in dire straits, we can advise you on steps to get the OWCP claims examiner to pay attention to your needs, such as contacting the Department of Labor’s district director, or the national director via mail.
February 12, 2020
Claims Examiner, Sr. in Springfield, IL
No, the examiner is only involved in performing the exam and providing the results to the claims processor.
January 13, 2020