Blue Cross of Idaho is seeking a Claim Examiner to review and adjudicate paper/electronic claims. Determine whether to return, deny or pay claims following organizational policies and procedures.
We are looking for a Claim Examiner with:
Experience: 1-year relevant experience
What a day may look like:
We are also looking for:
- Review claim and determine denial, acceptance or a need for further investigation.
- Recognize and reports issues and escalates, as necessary.
- Review existing claims for errors and omissions.
- Interpret and applies all business rules, policies and contract.
- Knowledge of medical terminology
- Ability to complete assigned individual tasks within scope
- Research and navigate web-based programs
- Work with detailed-oriented material
- Follow detailed workflow and instructions
- Verbal & Written Communication
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
This job has expired.