Disability Claims Examiner jobs in Ohio

Disability Claims Examiner reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner typically reports to a supervisor/manager. To be a Disability Claims Examiner typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)

R
Claims Examiner
  • Roundstone
  • Lakewood, OH FULL_TIME
  • Bywater Claims Examiner
    Founded in 2003, Roundstone is not your typical insurance company. We’re on a mission to help employers save on healthcare benefits so they can put those savings towards bettering their businesses and taking care of their employees
    Role Description
    As a Bywater Claims Examiner you will review medical, dental, and vision claims to determine appropriate payment. This role requires the ability to accurately process claims in a timely manner and manage service requests. Bywater Claim Examiners are subject matter experts and are often asked to explain claim processing or review previously paid claims for accuracy. To be successful in this role, one must be flexible, able to see the big picture while paying attention to small details, and able to manage their time independently.
    Key Duties & Responsibilities:
    • Ability to read, understand, and communicate medical benefits according to SPD language;
    • Prompt and timely processing of claims accurately according to established expectations (150 claims per day);
    • Process claims in accordance with benefit contracts, plan policies, and production/quality requirements;
    • Prior to claim adjudication, establish proof of loss by reviewing and understanding medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting an investigation of questionable claims;
    • Request and follow-up on additional information as needed for incomplete claims, including but not limited to COB, accident investigations, eligibility, etc.;
    • Familiar with and understands various fee schedules;
    • May include but are not limited to: processing claims, claim system testing, over/under payments and special projects.
    Desired Qualifications:
    • Knowledge of TPA administrative services, policies, procedures and systems, testing of plan setup;
    • 3 years experience processing Medical, Dental, Vision claims applying appropriate benefits;
    • Certified in Medical Terminology I, II and ICD9/10 knowledge;
    • Excellent verbal, communication, and written skills with strong organizational and research skills;
    • Proficiency in Microsoft Office (Word, Excel and Access);
    • Must be detail-oriented, have ability to work well under pressure, and handle multiple tasks with deadlines;
    • Bilingual (English/Spanish) skills a plus.
    Better Benefits:
    We’re leaders in our industry, so naturally, we look out for our employees’ best interests with a robust benefits package. Roundstone employees are eligible for:
    • Medical, dental and vision benefits
    • Annual bonus
    • Dependent care 100% match up to max allowable
    • PTO beginning on Day 1
    • Tuition reimbursement
    • Health work/life balance
    • Hybrid office schedule
    • 401(k) plan with company match
    • Employee Assistance Program
    • On-site gym with personal trainer access
    • Life insurance and short term disability insurance
    More About Roundstone
    Headquartered in Lakewood, Ohio, Roundstone is regularly recognized as a Northeast Ohio Top Workplace by the Plain Dealer and cleveland.com. We are especially proud to be recognized as a Top Workplace since this honor is determined by anonymous feedback from our own employees. Roundstone employees enjoy a supportive workplace where they are engaged, valued and regularly recognized for their hard work at monthly company meetings. Roundstone’s core values are evident every day and are shared with the community through the sponsorship of community events and outreach.
    Our Core Values
    • Live well: Be healthier and bring positive energy to all you do.
    • Work smarter: Get things done, better.
    • Own it: Accountability is your middle name. Be on time, do what you say, and finish what you start.
    • Be intellectually curious: Always be learning. See opportunity everywhere and have a drive to know.
    Culture and fit are integral to success and in an effort to achieve a better match both from a candidate's perspective and our organization, please take a minute, click on the link and take the really brief survey:
    https://go.apply.ci/p/XoefKbRCMZnL
    Don't meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At Roundstone Insurance we are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.
  • 13 Days Ago

U
Claims examiner
  • UST
  • Columbus, OH FULL_TIME
  • Claims Examiner UST HealthProof is looking for Claims Examiner, reporting to the Claims Team Leader, the Examiner is responsible for adjudication of healthcare claims utilizing employer and payer spec...
  • 2 Days Ago

S
Claims Examiner
  • Sheakley Group, Inc
  • Cincinnati, OH FULL_TIME
  • Job Summary The main responsibility of this position is to assist the Workers' Compensation Account Management Team with their administrative needs. We offer employees a range of perks including but n...
  • 6 Days Ago

V
Workers' Compensation Claims Examiner
  • V+A Risk Services
  • Toledo, OH FULL_TIME
  • Workers Compensation Claims Examiner Position Available V A Risk Services is an Ohio based TPA for workers’ compensation claims management services. We have stood ready to serve our valued clients sin...
  • 2 Days Ago

S
Claims Examiner - 100% Remote
  • S&S Healthcare
  • Cincinnati, OH FULL_TIME
  • S&S Health is a premier healthcare administration company located in Cincinnati, Ohio. We offer self, level, and fully funded solutions that lower costs while improving outcomes with a consumer-centri...
  • 3 Days Ago

W
Medical Claims Examiner
  • Wipro Limited
  • CANFIELD, OH FULL_TIME
  • The Claims Examiner position responsible for processing medical, dental and vision claims. This position is looking for someone to work in the Canfield Ohio office. Upon completion of training and sat...
  • 4 Days Ago

D
Interim Director of Human Resources
  • Dowbuilt
  • Los Angeles, CA
  • Dowbuilt is starting a search for an interim HR Director to step in 32 hours per week between May of 2024 and January of...
  • 4/19/2024 12:00:00 AM

L
Physician Assistant
  • Loyal Source Government Services
  • Las Vegas, NV
  • Do you have a passion for helping America’s heroes? If so, Loyal Source has an exciting opportunity for you to give back...
  • 4/19/2024 12:00:00 AM

V
Audiologist
  • Veterans Evaluation Services
  • Gary, IN
  • As an Audiology examiner you will conducting audiology exams and completing applicable disability benefits questionnaire...
  • 4/19/2024 12:00:00 AM

L
Audiologist
  • Loyal Source Government Services
  • Fremont, CA
  • Give Back to Those that Gave to Us We offer full- and part-time positions with excellent benefits – opportunities for gr...
  • 4/19/2024 12:00:00 AM

V
Dentist
  • Veterans Evaluation Services
  • Grand Rapids, MI
  • Your Role as a Provider As a clinician, you are an expert in the assessment, evaluation, and diagnosis of health conditi...
  • 4/19/2024 12:00:00 AM

N
Human Resources Specialist - Full Performance Level
  • National Reconnaissance Office (NRO)
  • Chantilly, VA
  • WE ARE THE NRO For sixty years, the NRO has developed, acquired, launched and operated the satellites that are the found...
  • 4/19/2024 12:00:00 AM

C
Environmental Health Safety Coordinator
  • Compunnel Inc.
  • Columbia, TN
  • Job Description The Health, Safety & Environmental Coordinator is responsible for: · Managing the Columbia Plant’s vario...
  • 4/19/2024 12:00:00 AM

U
Short Term Disability Claims Examiner I, II or Sr - Remote
  • USAble Life
  • Little Rock, AR
  • * Short Term Disability Claims Experience Required* When it comes to making a meaningful difference in the lives of our ...
  • 4/17/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disability Claims Examiner jobs
$48,894 to $60,708