Claims Examiner I

$46,966 - $67,683/Yr

Elevance Health - Rancho Cordova, CA

posted 4 months ago

Full-time - Entry Level
Remote - Rancho Cordova, CA
11-50 employees
Insurance Carriers and Related Activities

About the position

The Claims Examiner I position at Elevance Health is an entry-level role focused on developing claims knowledge and processing skills. The position is remote but associates may need to attend the Rancho Cordova, CA office for meetings or training. The role involves reviewing and evaluating claims, calculating benefit determinations, and utilizing reference materials to resolve issues. The position offers a starting wage range of $22.58 - $32.54 per hour and includes a comprehensive benefits package.

Responsibilities

  • Reviews and evaluates claims for information on which to base payment.
  • Manually calculates benefit determinations and re-enters claims using the PAC process.
  • Refers to policy overage and benefit limitations to determine appropriate actions.
  • Utilizes reference materials to research information and resolve problems.
  • Updates, manually processes, and adjusts claims and/or records as appropriate.
  • Prepares reports and/or logs as necessary.
  • Maintains inquiry tracking appropriately.

Requirements

  • Minimum of one year of Anthem Blue Cross medical claims processing experience or equivalent education.
  • Familiarity with basic arithmetic computations and data entry.
  • Knowledge of medical terminology and codes.
  • Effective communication and personal computer skills.

Nice-to-haves

  • Familiarity with medical claims processing or other health insurance experience.

Benefits

  • Employee stock purchase plan
  • Paid holidays
  • Disability insurance
  • Health insurance
  • Dental insurance
  • 401(k)
  • Paid time off
  • Vision insurance
  • 401(k) matching
  • Life insurance
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