Claims Examiner

We are seeking a meticulous Insurance Claims Examiner with expertise in medical billing and insurance practices.

The role involves scrutinizing patient insurance coverage, benefits, and eligibility to ensure seamless claims processing and accurate billing.

1. Examine patient insurance eligibility, coverage, and benefits for medical services.
2. Accurately enter and update insurance information in NextGen EMR.
3. Communicate with insurance companies to confirm benefits and resolve discrepancies.
4. Collaborate with healthcare providers, billing staff, and front-office personnel to ensure claims accuracy.
5. Assist in resolving prior authorization and referral requirements.
6. Maintain compliance with HIPAA and payer-specific guidelines.

• At least 3 years of relevant experience in insurance verification and claims examination.
• Background in medical billing and insurance administration preferred.
• Proficiency in NextGen software required.
• Strong understanding of healthcare insurance plans, coverage, and policies.
• Excellent attention to detail, organizational skills, and communication abilities.
• Ability to work independently in a remote environment.