Claims Examiner

UHS • Reno, NV

23h

About The Position

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 not 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.

Requirements

• High school diploma or equivalent required.
• 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.
• Strong commitment to confidentiality and ethical conduct in handling sensitive healthcare data.

Nice To Haves

• 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.
• Certification in Health Insurance Portability and Accountability Act (HIPAA) compliance is a plus.

Responsibilities

• Reviewing and adjudicating health insurance claims
• Ensuring accuracy compliance with policies and regulations
• Timely settlements
• Assessing claims
• Verifying information
• Communicating effectively with internal stakeholders, members, providers and their office staff and other insurance companies

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED