Job Type
Date Posted
Salary Range
Distance

Claims Examiner II Jobs

214 Jobs

  • 3.3
    Montana State Fund – Helena, MT
    7 days ago 7d
    Provides coaching and mentoring to ClaimExaminer Trainees and other ClaimsExaminers either as part of formal or informal mentoring… activities in accordance with the Claim Guidelines and industry Best Claim Practices. Runs II reports as needed to document medical…
  • 3.1
    Acceptance Insurance – Nashville, TN
    NEW
    Overview As a Casualty Claim Specialist II, you will be responsible for the investigation, evaluation, negotiation, disposition… motorist claims, minor scaring, surgical procedures recommended but not preformed, multiple competing claims, claims with potential…
  • 3.3
    L.A. Care Health Plan – Los Angeles, CA
    $42k-$65k(Glassdoor est.)
    HOT
    :  The ClaimsExaminerII is responsible for the accurate and timely processing of direct contract and delegated claims per regulatory… releasing pending claims when indicated. -Meeting and exceeding performance measurements for ClaimExaminers as required by the…
  • 3.5
    University Medical Center of El Paso – El Paso, TX
    $31k-$48k(Glassdoor est.)
    NEW
    Responsible for adjudicating claims, calculating benefits for manual processed claims, and adjudicating pending claims on reports. Must meet… other company Departments and providers who are experiencing claim issues or problems. Required Experience A. Work Experience…
  • 2.9
    Centene – Rancho Cordova, CA
    $50k-$76k(Glassdoor est.)
    NEW
    School Diploma or equivalent required. Three years health claimsexaminer and one year multiple product experience required… Documents provider claims/billing forms to support payments/decisions. Matches authorizations to claims, maintains current desk…
  • 3.6
    Desert Oasis Healthcare – Palm Springs, CA
    $35k-$56k(Glassdoor est.)
    7 days ago 7d
    Springs, California Department Claims Job Id 17-1868 Description ClaimsExaminerII will process for payment all encounters… ancillary, hospital, tertiary and specialist claims according to contract. -Adjudicate claims in accordance with Managed Care Operations…
  • 2.8
    LiveHealthier – Rancho Cordova, CA
    $33k-$51k(Glassdoor est.)
    NEW
    School Diploma or equivalent required. Three years health claimsexaminer and one year multiple product experience required… Documents provider claims/billing forms to support payments/decisions. Matches authorizations to claims, maintains current desk…
  • 3.0
    MHN – Rancho Cordova, CA
    $38k-$59k(Glassdoor est.)
    NEW
    School Diploma or equivalent required. Three years health claimsexaminer and one year multiple product experience required… Documents provider claims/billing forms to support payments/decisions. Matches authorizations to claims, maintains current desk…
  • 3.1
    State of Florida – Miami, FL
    $32k-$50k(Glassdoor est.)
    7 days ago 7d
    Agency: Veterans Affairs Working Title: VETERANS' CLAIMSEXAMINERII - 50000863 Position Number: 50000863 Salary:… Visit and provide on-site assistance, claims preparation and submission of claims to all Florida National Guard units in the…
  • 3.7
    National Indemnity Company – Omaha, NE
    $46k-$71k(Glassdoor est.)
    6 days ago 6d
    opening for an experienced ClaimExaminer. This individual will evaluate, manage and resolve claims reported under Company insurance… appropriate Claim Files and journals and all required electronic and other records, and provide information regarding claims as required…
  • 3.1
    State of Florida – Bay Pines, FL
    $32k-$51k(Glassdoor est.)
    NEW
    VETERANS' CLAIMSEXAMINERII - 50000846 Date: Dec 11, 2017 Location: BAY PINES, FL, US, 33731 Apply now… Agency: Veterans Affairs Working Title: VETERANS' CLAIMSEXAMINERII - 50000846 Position Number: 50000846 Salary: $38,659.92…
  • 3.0
    TRISTAR Insurance Group, Inc – Chicago, IL
    $38k-$58k(Glassdoor est.)
    8 days ago 8d
    Examiner III, but larger than those for ClaimsExaminer I.* Settles and/or finalize all claims and obtains authority as designated… clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently…
  • 3.2
    eviCore healthcare – Sacramento, CA
    $34k-$52k(Glassdoor est.)
    22 days ago 22d
    Overview The ClaimsExaminerII is responsible for processing claims for payment or denial with detailed assignment including… validation of claims for accuracy and completeness, confirmation of member eligibility, and verification of claim pricing and authorization…
  • 2.6
    TRISTAR Risk Management – Chicago, IL
    $37k-$56k(Glassdoor est.)
    8 days ago 8d
    Examiner III, but larger than those for ClaimsExaminer I.* Settles and/or finalize all claims and obtains authority as designated… clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently…
  • 2.9
    National General Insurance – Ontario, CA
    $54k-$78k(Glassdoor est.)
    NEW
    Purpose: Examineclaims data, investigate the facts of loss, determine coverage and liability, and adjusts claims within limit… as necessary Evaluate and adjust claims within limit of authority and summarize claims in excess of authority and submit to…
  • 2.5
    HMSA – Honolulu, HI
    8 days ago 8d
    of medical claims. A Claims Benefit Examiner is required to review and make benefit determinations on medical claims in accordance… cost containment measures to assist in the claim adjudication process • Process claim suspensions from the system to correct processing…
  • 2.5
    HMSA – Honolulu, HI
    $25k-$38k(Glassdoor est.)
    7 days ago 7d
    processing. ExaminerII also acts as a resource to BlueCard Examiner I. A BlueCard Home examiner processes claims and inquiries… A BlueCard ExaminerII processes routine to medium complexity level claims and claim inquiries for the BlueCard Unit which administers…
  • 3.1
    State of Florida – Miami, FL
    $32k-$50k(Glassdoor est.)
    9 days ago 9d
    Agency: Veterans Affairs Working Title: VETERANS' CLAIMSEXAMINERII - 50000863 Position Number: 50000863 Salary: Agency… Visit and provide on-site assistance, claims preparation and submission of claims to all Florida National Guard units in the…
  • Wellington Insurance Services, Inc. – Fort Worth, TX
    20 days ago 20d
    experienced ExaminerII and/or III to investigate, evaluate, negotiate, and resolve complex, personal lines property claims. This individual… customer service, as well as handle claims in accordance with prescribed authority and best claims practices. Essential Functions…
  • 3.0
    TRISTAR Insurance Group, Inc – Concord, CA
    $68k-$103k(Glassdoor est.)
    NEW
    Examiner I and ClaimsExaminerII.* Settles and/or finalize all claims and obtains authority as designated.* Maintains diary system… clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently…
  • 2.8
    SWBC – San Antonio, TX
    $27k-$41k(Glassdoor est.)
    30+ days ago 30d+
    complicated Payment Protection claims and determines if benefits are payable or not; ensures claims are adjudicated within the customer… determination on claims from insurance carrier, family, claimant, physicians, employers, and others. Submits all claims determined contestable…
  • 3.0
    TRISTAR Insurance Group, Inc – Sacramento, CA
    $55k-$84k(Glassdoor est.)
    26 days ago 26d
    clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently… regarding claims issues.* Computes and set reserves within Company/Client guidelines.* Settles and/or finalizes all claims and obtains…
  • 3.4
    Health First – Melbourne, FL
    $28k-$44k(Glassdoor est.)
    6 days ago 6d
    The HFHP Claim Analyst II is responsible and accountable for providing Quality / No Harm, Customer Experience, and Stewardship… that communication and resolution of claim issues occurs in a timely manner to allow claims processing to meet all State and Federal…
  • 2.6
    TRISTAR Risk Management – Houston, TX
    $50k-$77k(Glassdoor est.)
    Today 8hr
    Examiner I and ClaimsExaminerII.* Settles and/or finalize all claims and obtains authority as designated.* Maintains diary… clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently…
  • 3.7
    National Indemnity Company – Omaha, NE
    $43k-$67k(Glassdoor est.)
    NEW
    opening for a Claim Specialist II or ClaimExaminer. Claim Specialist II: The successful Claim Specialist II candidate will… within documented authority. ClaimExaminer I Evaluates, manages and resolves claims reported under Company insurance…
  • 2.6
    TRISTAR Risk Management – Sacramento, CA
    $59k-$90k(Glassdoor est.)
    26 days ago 26d
    clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently… regarding claims issues.* Computes and set reserves within Company/Client guidelines.* Settles and/or finalizes all claims and…
  • 3.2
    USAble Life – Little Rock, AR
    $49k-$74k(Glassdoor est.)
    15 days ago 15d
    for a ClaimsExaminer I, II or Sr. to join our dynamic team at USAble Life in Little Rock, Arkansas. The ClaimsExaminer I performs… staff on claims related issues. Updates tracking systems and processing systems as necessary. The ClaimsExaminerII performs…
  • 3.0
    TRISTAR Insurance Group, Inc – Santa Ana, CA
    $42k-$65k(Glassdoor est.)
    8 days ago 8d
    clients, claimants on the phone, and with management, other ClaimsExaminers, and other TRISTAR staff in the office; therefore consistently… and case facts. Establish claims reserves levels by estimating the cost of each assigned claim; monitor reserves and update…
  • 3.5
    Plymouth Rock Assurance – Berkeley Heights, NJ
    22 days ago 22d
    clients, outside attorneys, witnesses, physicians, courts, and Claims personnel to arrange trial dates, obtain information, respond… Strong interpersonal skills Understanding of the Legal and Claim operations Very good oral and written communications skills…
  • 5.0
    MEDsearch – Long Beach, CA
    $32k-$51k(Glassdoor est.)
    12 days ago 12d
    contracts with various health plans. POSITION SUMMARY ClaimsExaminer Primary Duties Responsible for processing of Medicare… High School Diploma or GED 3-5 years medical claimsexamining experience Knowledge of Medi-Cal and Medicare guidelines required…
Page 1 of 8
Work in HR or Recruiting?