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Claims Examiner
MM International Canfield, OH
$61k-78k (estimate)
Full Time | Business Services Just Posted
Save

MM International is Hiring a Claims Examiner Near Canfield, OH

Position : Claims ExaminerLocation : Canfield Ohio 44406 (Onsite)Duration : Full-Time (Permanent Role) Interviews will be onsiteJob DescriptionThe Claims Examiner position is responsible for processing medical, dental and vision claims.Review and process medical claims according to Plan guidelines within established turnaround time frames
Interpret medical plan to assure system is coded correctly
Review claims for legitimacy and accuracy
Meet production and quality standards set for examiners
Work Customer Service inquiries related to claim questions
Review correspondence submitted by members and providers and adjust all related claims if the additional documentation submitted warrants adjustment
Other duties as assigned
QualificationsHigh School/GED required
Demonstrate skills in problem solving and benefit plan interpretation
Knowledge of CPT codes, ICD10 codes and/or medical terminology is a plus
Ability to work independently
PC proficiency
Average typing ability
1 year's prior work experience in health care administration

Job Summary

JOB TYPE

Full Time

INDUSTRY

Business Services

SALARY

$61k-78k (estimate)

POST DATE

06/12/2024

EXPIRATION DATE

12/07/2024

WEBSITE

mandminternationalinc.com

HEADQUARTERS

HONOLULU, HI

SIZE

25 - 50

FOUNDED

2008

CEO

DENNIS MITSUNAGA

REVENUE

<$5M

INDUSTRY

Business Services

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The job skills required for Claims Examiner include Customer Service, Problem Solving, CPT, Claim Reviews, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Examiner. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Examiner. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Claims Examiner positions, which can be used as a reference in future career path planning. As a Claims Examiner, it can be promoted into senior positions as a Claims Examiner III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Examiner. You can explore the career advancement for a Claims Examiner below and select your interested title to get hiring information.

If you are interested in becoming a Claims Examiner, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Examiner for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Claims Examiner job description and responsibilities

Most medical claims examiners deal with paperwork on a daily basis and they are expected to work on multiple claims per day.

04/03/2022: Springfield, MA

Each claim often comes with supporting documents such as medical records and hospital bills and examiners need to look over each file carefully.

03/08/2022: Manchester, NH

Claims examiners are responsible for approving or rejecting claims or arranging settlements.

01/25/2022: Santa Fe, NM

Examiners may review medical bills or accident reports and they may consult specialists.

01/30/2022: Santa Barbara, CA

The Claims Examiner maintains a full case load of professional liability claims.

01/24/2022: Monroe, LA

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Claims Examiner jobs

Keep reading to learn more about a claims examiner role.

03/28/2022: Oklahoma City, OK

Candidates should know that having a critical thinking and outstanding decision-making give examiners the logic and reasoning to evaluate and resolve claims.

04/05/2022: Tulsa, OK

Most employers require or strongly prefer medical claims examiners that have some medical background such as a postsecondary diploma.

03/11/2022: San Antonio, TX

To determine whether a claim should be rewarded, an examiner must be aware of the red flags associated with fraudulent claims and possess detailed analysis skills.

01/30/2022: Bellingham, WA

To begin a career as a medical claims examiner, one must first learn certain knowledge and skills that will help them execute the duties of the job.

02/17/2022: Lawton, OK

Step 3: View the best colleges and universities for Claims Examiner.

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College