Claims Examiner jobs in Illinois
Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Examiner jobs
Claims Examiner
- Christian Brothers Services
-
Romeoville, IL
FULL_TIME
-
Position Information
Title:Claims Examiner
Posted:08/16/2023
Salary:
Description:
Our Health Benefit Services Division has a full-time opening for a Claims Examiner. This position is responsible for the timely and accurate adjudication of claims in accordance with established procedures and provisions of the benefit plans.
Christian Brothers Services is a not-for-profit comprised of cooperative programs providing administrative and managerial services to Catholic organizations. We offer a competitive benefits package!
Qualifications:
Responsibilities:
- Examine medical/dental/vision claims with responsibility for efficient, accurate evaluation of data and initiation of benefit payment.
- Follow up/follow through on pended claims by evaluating all new and existing supporting documentation for determination of benefits within one week of receipt.
- Collaborate with the Customer Care department to resolve phone inquiries about claims within 24 to 48 hours for urgent issues and one week for standard issues.
- Communicate via telephone or email with members, employers, care providers, and service providers regarding status/circumstances for the resolution of claims.
- Exercise good judgment and in a timely manner when determining escalation of a claim to a Claims Team Lead, Supervisor or internal nurse review (HCR).
- Perform other claim department duties related to adjudication as assigned
- Help identify any system of workflow performance issues
- Twice daily monitoring of individual and departmental workload through computerized reports
Qualifications:
- High School diploma
- minimum of two to five years' claim adjudication experience in a PPO environment
Skills:
- Good analytical skills and a working knowledge of medical coding and terminology
- previous Trizetto processing system experience helpful
- Must be familiar with standard concepts, practices, and procedures related to medical billing
- Familiar with MS applications, including Word, Excel, and basic webpage navigation
- Accurate calculator skills and a minimum typing speed of 40 wpm required
- Must be self motivated, dependable, and detail oriented with excellent communications and problem solving skills
Contact Information
Contact:Human Resources
Address:1205 Windham Parkway
Romeoville, IL 60446 - 12 Days Ago
Claims Examiner
- Partnered Staffing - Kelly Services
-
Jacksonville, IL
FULL_TIME
- Company DescriptionAt Kelly Services, we work with the best. Our clients include 99 of the Fortune 100 TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best tale...
- 1 Month Ago
Senior Claims Examiner - Liability
- Crawford & Company
-
Zurich, IL
OTHER
- Excellence In Everything We Touch Position Summary Investigate and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on m...
- 10 Days Ago
AVP, Sr. Claims Examiner
- Berkley
-
Chicago, IL
OTHER
- Company Details At Berkley Alliance Managers, we offer innovative coverage and risk management solutions for our brokers and policyholders. We have a passion for offering fresh ideas and relevant insu...
- 1 Month Ago
Claims Examiner or Associate Claims Examiner- Property Oak Brook IL
- USLI
-
Brook, IL
FULL_TIME
- The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertiv...
- 13 Days Ago
Senior Commercial General Liability Claims Examiner
- KING'S INSURANCE STAFFING LLC
-
Scottsdale, IL
FULL_TIME
- Our client, an A-rated Insurance Carrier, is seeking to add a Senior Commercial General Liability Claims Specialist. This person would be responsible for directly handling moderate to complex litigate...
- 1 Month Ago
Claims Examiner jobs at Popular Companies
Claims Examiner
- JCW
-
- JCW is currently recruiting on behalf of a rapidly growing Property & Casualty Insurance Company who are looking to add ...
- 4/23/2024 12:00:00 AM
Claim Examiner
- Kansas City Life Insurance Company
-
Kansas City, MO
- QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in business field, related field, or equivalent work ex...
- 4/22/2024 12:00:00 AM
Claims Examiner
- The Jonus Group
-
Chicago, IL
- We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
- 4/22/2024 12:00:00 AM
Claims Examiner
- The Jonus Group
-
New York, NY
- We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
- 4/22/2024 12:00:00 AM
Claims Examiner
- The Jonus Group
-
Phoenix, AZ
- We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
- 4/22/2024 12:00:00 AM
Claims Examiner
- D3 Search
-
Los Angeles, CA
- D3 Search is actively seeking the following Claims Examiner II - Cyber candidate for a highly respected global insurer w...
- 4/22/2024 12:00:00 AM
Claims Examiner
- The Jonus Group
-
White Plains, NY
- We are seeking a Senior Claims Examiner to join our team. The Senior Claims Examiner will play a pivotal role in managin...
- 4/22/2024 12:00:00 AM
Claim Examiner
- Kansas City Life Insurance Company
-
Kansas City, MO
- QUALIFICATIONS/REQUIREMENTS: Bachelor of Arts or Sciences degree in business field, related field, or equivalent work ex...
- 4/21/2024 12:00:00 AM
About Illinois
Illinois (/ˌɪlɪˈnɔɪ/ (listen) IL-ih-NOY) is a state in the Midwestern and Great Lakes region of the United States. It has the fifth largest gross domestic product (GDP),
the sixth largest population, and the 25th largest land area of all U.S. states. Illinois is often noted as a microcosm of the entire United States. With Chicago in northeastern Illinois, small industrial cities and immense agricultural productivity in the north and center of the state, and natural resources such as coal, timber, and petroleum in the south, Illinois has a diverse economic base, and is a major transportation hu...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,964 to $64,929