Claims Examiner
About the Role
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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
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Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.
Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, and a passion for innovation, creativity and continuous improvement.
Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.
We look forward to working with you.