Claims Examiner Jobs

Claims ExaminerDesert Valley Medical Group

Examining and adjudicating healthcare claims is the core of this role, applying established policies, procedures, and processing standards. This full-time weekday opportunity is ideal for an experienced claims professional with strong attention to detail, sound judgment, and a commitment to…

Claims ExaminerTokio Marine HCC – Surety Group

This Associate Claims Examiner position is an on-site role in Los Angeles, California, focusing on objectively investigating and analyzing surety bond claims.

Claims ExaminerOneMain Holdings, Inc.

This role involves evaluating and processing claims to determine if they are payable, deferred, or declined. The Claims Examiner ensures claims are handled according to policy provisions, regulatory requirements, and company guidelines, while providing timely and professional correspondence to…

Examiner - ClaimsWestern Financial Group

The Claims Examiner will be a key member of the National Insurance Operations team, reporting to the Claims Manager. This role involves collaborating with partners and clients to resolve property and casualty claims, ensuring policy wordings are interpreted correctly and claims are managed…

Claims ExaminerBanner Life Insurance Company

Determining and requesting the documentation, evidence, and investigations needed to adjudicate complex claims is a core part of this role. The Claims Examiner independently adjudicates complex and higher-risk life and health claims that require advanced contractual analysis, including contestable…

This role involves performing Third Party Administrator (TPA) responsibilities, providing delegated claims administration and management services on behalf of Lloyd’s Syndicates.

Claims ExaminerVIP Universal Medical Insurance Group (VUMI)

The Claims Examiner reviews insurance claims according to policy conditions and makes decisions regarding those claims. In this role, you will investigate and resolve travel insurance claims by assessing facts and supporting documentation, interpreting applicable policy provisions…

Claims ExaminerIndependent Living Systems (ILS)

Caring for vulnerable populations by ensuring the accuracy and compliance of insurance claims is the core of this role. The Claims Examiner reviews and evaluates claims, analyzes medical documentation and billing information, and collaborates with healthcare providers and internal…

The Claims Examiner reviews, analyzes, and processes healthcare insurance claims, ensuring accuracy, completeness, and compliance with company policies and regulations.

Claims ExaminerRAS

This home-based role is for a seasoned workers' compensation professional who will work with clients to control costs and exposure, and help injured workers return to work. You will handle workers’ compensation claims involving litigated, loss time, and complicated medical claims.

This position is within the Specialty Programs Department, Veteran and Family Member Programs (VFMP), within the Veterans Health Administration (VHA). The role involves processing medical claims and applying comprehensive knowledge of provider relations, reimbursement methods, coordination of…

Claims ExaminerCACI

This role involves managing and reviewing workers' compensation claims as a Claims Examiner. The core of the job is investigating and processing insurance claims, negotiating settlements, and maintaining accurate claims records.

Claims ExaminerSigma Inc.

This contract role involves reviewing, analyzing, researching, and resolving complex medical claims in accordance with processing guidelines and federal regulations.

Claims ExaminerMarkel

This role is responsible for resolving claims of average complexity and low to mid exposure. The primary purpose of this job is to investigate, evaluate, negotiate, and settle assigned claims by collecting and analyzing data according to policy application and contract provisions.

Claims ExaminerCommunity Care Plan

Examining and processing health insurance claims accurately and on time is the main focus of this role, ensuring compliance with department standards. The position involves reviewing claims based on various guidelines and identifying complex issues for resolution.

Claims ExaminerJT2 Integrated Resources

This role involves managing workers' compensation claims from beginning to end, ensuring adherence to best practices and California state statutes. The Claims Examiner will work with various stakeholders including clients, injured workers, agents, vendors, and attorneys.

Claims ExaminerSunrise Systems, Inc.

The Claims Examiner investigates and settles claims promptly and equitably, adhering to established best practices. This role involves reviewing policy information, contacting various parties to gather information, and evaluating facts to determine liability and company obligations.

Claims ExaminerProctor Loan Protector

The Claims Examiner reviews property claims to ensure compliance with internal and statutory requirements for timely and accurate review, best practices, documentation, adjustment, and indemnity approval. For liability claims, the position coordinates with the carrier and assigned adjusting firms.

Claims ExaminerImagine360

Caring for self-funded groups by properly applying plan provisions is the core of this role. The Claims Examiner processes medical, dental, and vision claims, answers related questions, and works with other departments to resolve client concerns while maintaining a comprehensive…

Claims ExaminerArizona Priority Care (AZPC)

The Claims Examiner adjudicates medical claims and responds to inquiries, ensuring accurate and timely processing. This role suits a customer-focused, energetic, and detail-oriented individual who can work both independently and as part of a team.

Claims ExaminerAmeriHealth Caritas

This role involves reviewing and processing healthcare claims, ensuring they align with contractual agreements and processing guidelines. The Claims Examiner supports the team by handling complex claims and maintaining high standards of quality and production.

Claims ExaminerStaff Judge Advocate Claims Division

This role involves serving as a Claims Examiner for the Staff Judge Advocate Claims Division, focusing on the investigation, review, and development of all claims against and on behalf of the United States.

Claims ExaminerRobert Half

This fully remote contract opportunity involves supporting a healthcare claims review and audit project focused on commercial health plans. The role plays a key part in evaluating claims accuracy, identifying compliance risks, and supporting audit-related initiatives, and suits a candidate with…

Claims ExaminerUPMC Health Plan

This full-time Claims Examiner role supports the Claims Operations Department by reviewing provider-submitted claims to determine eligibility for payment or denial.

Claims ExaminerMSH

Caring for a large caseload of claims and meeting tight deadlines is the core of this role, which suits an experienced Claims Examiner who thrives in a fast-paced environment.

Claims ExaminerNetwork Adjusters

This high-visibility position involves reviewing existing claim files for closure with current carrier partners and assisting with onboarding triage and review of new claim programs.

Claims ExaminerChubb

Caring for workers' compensation claims that involve lost time is the main focus of this role, which requires a commitment to superior performance and strong customer service skills. The position is based in the company's Alpharetta office.

Claims ExaminerARAG Legal Solutions Inc.

Reporting to the Claims Manager, the Claims Examiner will support the company's expansion and strengthening presence across Canada in the legal expense insurance market.

Claims ExaminerBRMS

This Claims Examiner I role is responsible for ensuring that claims are correctly coded and processed, meeting all production requirements. The position involves processing claims by comparing data with internal policies and company records to verify completeness and validity.

This position is responsible for analyzing and processing facility, ancillary, and physician claims, checking them for validity. The Claims Examiner reviews claims for various items, including appropriate billing practices and coverage based on Health and Welfare Guidelines, and…

Claims ExaminerMarsh McLennan Agency Midwest

Caring for and resolving medical professional liability claims is the main purpose of this role. The Claims Examiner provides exceptional customer service and works with various stakeholders to ensure claims are managed and resolved accurately and on time.

Claims ExaminerAllianz Partners

This role involves reviewing and assessing insurance claims, making informed decisions based on policy guidelines, and ensuring claims are resolved accurately, efficiently, and with a customer-first mindset. The Claims Examiner plays a key role in delivering exceptional service to customers.

Claims ExaminerSymetra

The Life Claims Examiner is responsible for the timely adjudication of group life and AD&D claims, verifying eligibility, and making initial claim decisions based on policy provisions. This role requires a strong desire to provide world-class service to both internal and external customers.

Claims ExaminerHornet Staffing, Inc.

This claims examiner role involves accurately processing and adjudicating healthcare claims, ensuring compliance with industry standards. It suits a detail-oriented individual with experience in healthcare claims processing on the insurance side.

Claims ExaminerGlobal IT Resources, Inc.

This role involves processing medical claims to ensure accurate and timely payment resolution. The company is hiring for both a Claims Examiner and a Senior Claims Examiner, with the senior position handling more complex claims, adjustments, and training responsibilities.

The Claims Examiner reviews and evaluates criminal injury compensation claims, determining eligibility and awards in accordance with Virginia law and agency policies.

Claims Examiner or Associate Claims Examiner - Liability ClaimsUSLI

This role involves evaluating coverage, liability, and damages for unique claims, collaborating with internal teams and external stakeholders to investigate, negotiate, and resolve them. It suits a professional with strong analytical and communication skills who is committed to making a difference.

Claims Examiner - Subrogation ClaimsAuto-Owners Insurance

This claims examiner position focuses on subrogation claims, helping individuals and businesses achieve financial security after a loss. The role involves reviewing claim files, assisting with determinations, and managing the arbitration process within a team of caring associates.

Claims ExaminerNetwork180

This claims examiner position is responsible for processing, adjusting, and paying claims accurately that are submitted by the company's provider network. The role suits an individual passionate about making a difference by helping others in the community.

Claims ExaminerNTT Data Services

Reviewing and processing insurance claims is the core responsibility of the Claims Examiner role. This position suits individuals who are detail-oriented and able to navigate complex situations in the healthcare insurance industry.

Claims ExaminerSedgwick

This role involves analyzing and processing complex workers' compensation claims for clients, ensuring timely resolution and adherence to industry best practices.

Claims ExaminerKaiser Permanente

Through comprehensive assessment and analysis, the Claims Examiner adjudicates managed healthcare claims and bills, authorizations, and referrals for payment or denial within contract agreements and regulatory requirements.

Liability Claims ExaminerU.S. Xpress

The Liability Claims Examiner is responsible for reviewing, evaluating, and settling property damage claims to ascertain the extent of exposure for commercial motor carriers.

Claims Examiner ITRISTAR

This Claims Examiner I position involves managing all aspects of medical-only claims from start to finish, working within established guidelines and authority.

Medical Claims ExaminerTEKsystems

Working with medical claims, the Medical Claims Examiner reviews, researches, and processes a variety of Medi-Cal claims, ensuring accuracy, quality, and compliance with established guidelines.

Senior Claims ExaminerCanopius

This role is responsible for adjusting primary and excess cyber claims, including reviewing and approving delegated claims that exceed TPA authority. The Senior Claims Examiner analyzes coverage, ensures appropriate coverage letters are sent, and participates in TPA audits and monthly report…

Claims Examiner, CasualtyStarr

This role involves the active management of casualty claims within the Canadian Claims Group for a global leader in commercial insurance. It suits a candidate with prior experience in handling casualty claims, including auto bodily injury and accident benefits, who can evaluate coverage, manage…

This role involves the highly complex review and adjudication of medical claims, including advanced claim history analysis and the resolution of complex appeals and reconsiderations.

Senior Claims ExaminerBerkley Re

The Senior Claims Examiner manages and analyzes a diverse portfolio of reinsurance claims across multiple lines of business, ensuring timely and accurate handling.

Senior Examiner, ClaimsMolina Healthcare

This senior examiner position provides support for claims examination activities. The core of the role involves evaluating the adjudication of claims to identify incorrect coding, abuse, fraudulent billing practices, waste, overpayments, and processing errors.