Claims Examiner

CRP Informationssysteme GmbH

Multiple Locations
Base: $20-$25ph; bonus/equity: not specified; bene...
Claims management systems
Policy provisions analysis
Documentation and record keeping
Evaluate incoming claims to determine eligibility, coverage, and validity, conducting thorough investigations and analyzing policy provisions

Job Summary

  • Evaluate incoming claims to determine eligibility, coverage, and validity, conducting thorough investigations and analyzing policy provisions.
  • Communicate effectively with policyholders, beneficiaries, and healthcare providers, providing timely responses and maintaining professional, empathetic communication.
  • Ensure compliance with company policies, procedures, and regulatory requirements while maintaining accurate records and participating in quality assurance initiatives.

Matching Summary

Evaluate incoming claims to determine eligibility, coverage, and validity, conducting thorough investigations and analyzing policy provisions.

Salary

Base: $20-$25/hr; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • claims management systems
  • policy provisions analysis
  • documentation and record keeping
  • regulatory requirements compliance
  • customer service communication

Nice-to-have

  • process improvement identification
  • quality assurance initiatives
  • best practices collaboration
  • data analysis on claims trends

Key Requirements

  • Claims processing experience
  • Reviewing medical records
  • Policy interpretation skills
  • Claims adjudication guidelines

Work Rights

Not specified

Tailored Resume

Cover Letter