Claims Examiner I
Posted 2026-05-05
Remote, USA
Full-time
Immediate Start
- Job Description:
- Under general supervision, assesses claim information, references contracts and performs calculations and other functions to accomplish the processing and payment of insurance claims of a complicated or non-routine nature
- Interprets contract information and communicates with outside parties to obtain information and coordinate coverage
- Performs claim research and adjustments
- Successfully completes all training programs as required for the level
- Processes claims for two products or claim types (dental, hospital, medical, ITS, FEP)
- Responds to written inquiries from internal and external customers as business needs dictate
- Requirements:
- High school diploma or general education degree (GED)
- 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience
- Advanced Keyboarding Knowledge
- Intermediate knowledge of Microsoft Office
- Knowledge of FACETS and/or other computerized claims processing system as applicable (FEP)
- Associates degree from college or technical school
- Benefits:
- Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
- Annual incentive bonus plan based on company achievement of goals
- Time away from work including paid holidays, paid time off and volunteer time off
- Professional development courses, mentorship opportunities, and tuition reimbursement program
- Paid parental leave and adoption leave with adoption financial assistance
- Employee discount program