Top 195 Claims processing examiner Jobs

Claims - Claims Examiner
Wellcove —Remote
- Full-time
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
Quick Apply
Claims Examiner - Remote
ImagenetLLC —Remote
- Full-time
- Remote
- Basic math
- Mid-level
- Data entry
- Paid training
- Health savings account
13d
Healthcare Claims Examiner, Remote
NTT DATA —Tampa, FL
- $18 an hour
- Temporary
- Remote
- Microsoft Outlook
- Computer literacy
- HIPAA
Quick Apply
Workers Compensation Claims Examiner (California Jurisdiction)
Elite —Remote
- Urgently hiring
- Remote
- Management
- Bachelor of Science
- Basic math
- On-the-job training
Quick Apply
Workers Compensation Claims Examiner (TEXAS Jurisdiction)
Elite —Remote
- Urgently hiring
- Remote
- Management
- Bachelor of Science
- Basic math
- On-the-job training
Quick Apply
Claims Examiner
Advanced Medical Pricing Solutions —Phoenix, AZ
- Writing skills
- HIPAA
- Research
- Dental insurance
Quick Apply
Casualty Claims Examiner ($2,500 Sign-On)
GEICO —Richardson, TX
- Full-time
- Hybrid work
- Office
- Senior level
- Communication skills
10d
Sr. Medical Claims Examiner Representative
Motion Picture Industry Pension & Health Plans —Los Angeles, CA
- $28 an hour
- Extended hours
- Microsoft Outlook
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
3d
SBS - Claims Examiner
Choice Medical Group —Camarillo, CA
- $22 - $32 an hour
- Full-time
- Background check
- Customer service
- Urgent Care
- Health insurance
- Dental insurance
Quick Apply
Claims Examiner I
MetroPlusHealth —New York, NY
- $50,000 - $54,194 a year
- Hybrid work
- Surgery
- Mid-level
- Associate's degree
Quick Apply
2d
Claims Examiner
Vaco by Highspring —Brookhaven, GA
- $60,000 - $65,000 a year
- Mid-level
- Bachelor's degree
- Continuous improvement
- Health insurance
- Dental insurance
Quick Apply
10d
Claims Examiner
Point C —Bellingham, WA
- $19 - $22 an hour
- Overtime
- Mid-level
- 1 year
- Associate's degree
- Health savings account
- Disability insurance
Quick Apply
PET INSURANCE CLAIMS EXAMINER/ADJUSTER 1099 INDEPENDENT CONTRACTOR
Administrative Strategies —Remote
- Weekends as needed
- Background check
- Spanish
- Anatomy knowledge
- Pet insurance
Quick Apply
Claims Investigator/Examiner
AIDS Healthcare Foundation —Los Angeles, CA
- $34 - $36 an hour
- Mid-level
- Organizational skills
- Health insurance
Quick Apply
Claims Examiner
Texas Children's Hospital —Houston, TX
- Full-time
- Research
- High school diploma or GED
- 1 year
Claims Examiner II
Partnership HealthPlan of California —Fairfield, CA
- $31.45 - $37.74 an hour
- Full-time
- Research
- Mid-level
- Office
Claims Examiner
Heritage Insurance —Sunrise, FL
- Overtime
- Background check
- Research
- Mid-level
Quick Apply
Medical Claims Examiner Remote
NTT Ltd —Plano, TX
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- HIPAA
5d
Claims Examiner Team Leader | Remote
ImagenetLLC —Remote
- Up to $22 an hour
- Full-time
- Remote
- 5 years
- Analysis skills
- Supervising experience
- Paid training
- Health savings account
6d
Workers Compensation Claims Examiner
Association County Commissioners of GA —Atlanta, GA
- From $75,000 a year
- Full-time
- Remote
- Basic math
- English
- Mid-level
Quick Apply

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Claims - Claims Examiner

Wellcove
Remote

Quick Apply

Job Details

Full-time

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
Medical claims processing software
High school diploma or GED
Medical terminology

Full Job Description

Who We Are
Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs.

Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

The Long-Term Care (LTC) Claims Examiner is responsible for the accurate and timely adjudication of long-term care insurance claims. This role ensures compliance with policy provisions, regulatory requirements, and company standards while delivering a high level of customer service to policyholders, providers, and internal stakeholders.

Review, evaluate, and adjudicate Long Term Care claims in accordance with policy provisions and established guidelines
Analyze claim documentation including invoices, care plans, and provider credentials
Apply knowledge of Coordination of Benefits (COB), Medicare, Medicaid, and other payer sources when applicable
Ensure claims are processed within established turnaround times and service level agreements (SLAs)
Communicate effectively with policyholders, providers, and internal teams regarding claim status, requirements, and determinations
Identify and request additional documentation when necessary to support claim decisions
Maintain accurate and detailed claim notes in system of record
Ensure compliance with HIPAA and all applicable regulatory and privacy requirements
Participate in quality assurance activities and implement feedback for continuous improvement
Support training and mentoring of new or junior staff as needed
Required Qualifications
High school diploma or equivalent required; associate or bachelor’s degree preferred
2+ years of experience in insurance claims, healthcare administration, or Long-Term Care claims processing
Strong understanding of Long-Term Care policies, benefits, and eligibility criteria preferred
Knowledge of medical terminology and healthcare documentation
Proficiency in claims systems and Microsoft Office (Excel, Word, Outlook)
Strong analytical and decision-making skills
Excellent written and verbal communication skills
Ability to manage multiple priorities in a fast-paced environment

Core Competencies

Attention to Detail
Critical Thinking & Problem Solving
Customer Focus
Time Management & Productivity
Compliance & Risk Awareness
Team Collaboration

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Quick Apply

Refine Your Search

claims processing examiner jobs

Claims - Claims Examiner

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Claims Examiner

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Medical Claims Examiner Remote

Claims Examiner Team Leader | Remote

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