Claims Examiner

Location
Silver Spring, MD
Posted
Jul 31, 2019
Closes
Aug 16, 2019
Ref
222210
Function
Administrative, Other
Industry
Insurance
Hours
Full Time
Job Summary/Company:

Sparks Group has partnered with a prominent organization in Silver Spring that is looking to hire a Claims Examiner to support members of a dynamic insurance environment. The ideal candidate will possess outstanding organization, attention to detail and analytical skills as well as the ability to anticipate problems and create plans to overcome issues.

Responsibilities:

  • Review Stop Loss claims to determine receipt of documents necessary to support the requirements of the policy for eligibility and benefits.
  • Develop written requests for additional information to Claims Administrators.
  • Consistently review files to determine appropriate follow-up actions.
  • Adjudicate Claims according to policy provisions and generate payment requests timely and accurately.
  • Assist claims support team with other duties as needed.

Qualifications:

  • High school diploma or equivalent work experience
  • At least 2 years administrative experience, preferably in an insurance environment
  • Microsoft Office proficiency
  • Working knowledge of insurance terminology, medical terminology, ICD-9, CPT-4, and HCSPC coding required

Qualified candidates should send their resume AND call Sparks Group for additional details. Please note, resume must include a valid email address in order to be considered. We look forward to discussing your background, your current job search, and your potential career path with Sparks Group!

Sparks Group is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, pregnancy, citizenship, family status, genetic information, disability, or protect veteran status.