Claims Examiner

Location
Silver Spring, MD
Posted
Oct 18, 2021
Closes
Oct 25, 2021
Ref
229723202110
Function
Accountant, Finance
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 bring experience adjudicating claims from start to finish.

Responsibilities:

  • Receive and review stop loss claims
  • Determine receipt of all necessary documents for eligibility and benefits
  • Develop written requests for additional information to Claims Administrators
  • Review documents to determine follow-up actions
  • Adjudicate claims according to policy and generate payment requests
  • Handle routine phone and written requests
  • Assist claims support team as required

Qualifications:

  • High school diploma or equivalent work experience
  • Minimum 2-3 years of claims processing
  • Insurance industry knowledge is a plus
  • Working knowledge of insurance terminology, medical terminology, ICD-9, CPT-4, and HCSPC coding required
  • Strong written and oral communication skills
  • Microsoft Office proficiency

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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.