To Apply for this Job Click Here
Beacon Hill is hiring! We have partnered with a health insurance company in hiring a Claims Examiner to start immediately. This position is 100% remote and is a contract role through the end of the year.
What You’ll Do
- Review and evaluate incoming insurance claims for accuracy, completeness, and eligibility
- Investigate claims by gathering documentation, medical records, policy information, and supporting evidence
- Determine coverage, liability, and claim outcomes based on policy provisions and company guidelines
- Communicate with policyholders, healthcare providers, attorneys, brokers, and internal stakeholders regarding claim status and requirements
- Analyze medical documentation and claim-related information to make informed decisions
- Authorize claim payments, settlements, denials, or referrals as appropriate
- Maintain accurate and detailed claim files within the claims management system
- Identify potential fraud indicators and escalate concerns when necessary
- Ensure compliance with insurance regulations, company policies, and service standards
- Respond to inquiries and resolve claim issues in a timely and professional manner
- Collaborate with internal teams to improve claims processes and customer experience
- Monitor claim progress and manage a caseload efficiently while meeting productivity goals
Qualifications
- Bachelor’s degree preferred
- 2+ years of experience in insurance claims handling, claims examination, claims adjudication, or related insurance operations
- Experience reviewing medical, disability, life, accident, health, or professional liability claims preferred
- Strong analytical, investigative, and decision-making skills
- Ability to interpret insurance policies and coverage provisions
- Excellent written and verbal communication skills
- Strong attention to detail and organizational skills
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency with Microsoft Office Suite and claims management systems
- Customer-focused mindset with a commitment to quality service
A1471122CHI_1787152272