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Claims Examiner
Posted 30+ days ago
Office Assistant (2349)
Posted 2 weeks ago

Court Security Officer, Fargo, ND
$1,000+ / project
Posted 30+ days ago

Samsung Home Theater Specialist
$15 - $18 / hour
Posted 6 days ago

Registered Nurse (Rn) - Nicu - (.75) FTE
$37 - $55 / hour
Posted 2 weeks ago

Registered Nurse (Rn) Nicu - PRN
$37 - $55 / hour
Posted 2 weeks ago

Physician - Pediatrician - Bismarck, ND
$276,000 - $1,000,000 / year
Posted 30+ days ago

Merchandising Assistant Manager
Posted 30+ days ago
Logistics Tech- Part Time (350)
$16 - $21 / hour
Posted 30+ days ago

Virtual Design & Construction (Vdc) Engineer I/Ii
Posted 2 days ago

Sonographer | PRN
$32 - $49 / hour
Posted 30+ days ago

Physician - Non-Invasive Cardiology Advanced Imaging - Fargo, ND
Posted 30+ days ago

Np/Pa - Spine Program - Fargo, ND
$113,880 - $159,432 / year
Posted 30+ days ago

Crane Operator
Posted 6 days ago

Account Manager - Personal Lines
Posted 30+ days ago

Technical Media Producer (Primary) - Kfyr
Posted 1 week ago

Faculty | Speech-Language Pathology
Posted 5 days ago

Remote Bilingual Interpreter
Posted 30+ days ago

Finishing Technician I
Posted 4 weeks ago

Flex CT Technologist
$40+ / hour
Posted 30+ days ago

Claims Examiner
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Overview
Job Description
Responsibilities & Duties:Claims Processing and Assessment:
- Evaluate incoming claims to determine eligibility, coverage, and validity.
- Conduct thorough investigations, including reviewing medical records and other relevant documentation.
- Analyze policy provisions and contractual agreements to assess claim validity.
- Utilize claims management systems to document findings and process claims efficiently.
Communication and Customer Service:
- Communicate effectively with policyholders, beneficiaries, and healthcare providers regarding claim status and requirements.
- Provide timely responses to inquiries and maintain professional and empathetic communication throughout the claims process.
- Address customer concerns and escalate complex issues to senior claims personnel or management as needed.
Compliance and Documentation:
- Ensure compliance with company policies, procedures, and regulatory requirements.
- Maintain accurate records and documentation related to claims activities.
- Follow established guidelines for claims adjudication and payment authorization.
Quality Assurance and Improvement:
- Identify opportunities for process improvement and efficiency within the claims department.
- Participate in quality assurance initiatives to uphold service standards and improve claim handling practices.
- Collaborate with team members and management to implement best practices and enhance overall departmental performance.
Reporting and Analysis:
- Generate reports and provide data analysis on claims trends, processing times, and outcomes.
- Contribute to the development of management reports and presentations regarding claims operations.
Automate your job search with Sonara.
Submit 10x as many applications with less effort than one manual application.
