Claims Examiner The Claims Examiner is responsible for evaluating and processing claims on primarily one business.../product line by performing all functions required to determine if the claim is or is not payable/deferred/or cancelled...
policy coverage, determine cause of loss, and document activity on each claim to come to a resolution quickly and accurately... review and analysis of application to the individual claim. With supervisor approval, negotiate with policyholders to settle...
-oriented, precise, and thorough. Extensive knowledge of medical claim processing procedures and guidelines. Ability to work.... Must have strong organizational skills, problem solving, and decision making skills. Knowledge of claim adjudication and benefit plan application...