Claims Examiner, Sr. jobs in Sun Valley, 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
  • 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

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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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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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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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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...
  • 25 Days Ago

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0 Claims Examiner, Sr. jobs found in Sun Valley, NV area

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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...
  • 4/24/2024 12:00:00 AM

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Safety Manager
  • The Clorox Company
  • Reno, NV
  • Clorox is the place that’s committed to growth – for our people and our brands. Guided by our purpose and values, and wi...
  • 4/23/2024 12:00:00 AM

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HEAVY EQUIPMENT OPERATOR (INCLINE VILLAGE)
  • Washoe County, NV
  • Reno, NV
  • Salary: $59,696.00 - $77,584.00 Annually Location : Incline Village, NV Job Type: Full Time Job Number: 60008243 (03/202...
  • 4/23/2024 12:00:00 AM

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Safety Manager
  • The Clorox Company
  • Reno, NV
  • Clorox is the place thats committed to growth for our people and our brands. Guided by our purpose and values, and with ...
  • 4/23/2024 12:00:00 AM

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Construction Safety Manager
  • Sterling Infrastructure Inc.
  • Reno, NV
  • Road and Highway Builders is looking for an experienced Safety Manager! Summary This position works with the Area Manage...
  • 4/23/2024 12:00:00 AM

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Construction Safety Manager
  • Sterling Infrastructure, Inc.
  • Reno, NV
  • Road and Highway Builders is looking for an experienced Safety Manager! Summary This position works with the Area Manage...
  • 4/22/2024 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...
  • 4/21/2024 12:00:00 AM

Sun Valley is a census-designated place (CDP) in Washoe County, Nevada, United States. The population was 19,299 at the 2010 census. It is north of Reno and is part of the Reno–Sparks Metropolitan Statistical Area. The community is located within Sun Valley approximately three miles north of Reno on Nevada State Route 443. According to the United States Census Bureau, the CDP has a total area of 14.9 square miles (38.6 km2), all land....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$62,605 to $80,715
Sun Valley, 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