Medical Claims Specialist Examiner Job Responsibilities:
Serves medical insurance customers by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality customer services; ensuring legal compliance.
Medical Claims Specialist Examiner Job Duties:
Documents medical claims actions by completing forms, reports, logs, and records.
Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.