Job Title: Medical Claims Examiner

Location: Richmond, Virginia

Job Type: Contract to Hire

Job Description:

A reputable healthcare organization in Richmond, Virginia, is seeking a detail-oriented and experienced Medical Claims Examiner. This role is essential for ensuring accurate and timely processing of medical claims. The ideal candidate will have a strong background in medical claims examination, excellent analytical skills, and a commitment to maintaining the highest standards of accuracy and compliance.

Key Responsibilities:

• Review and process medical claims in accordance with established guidelines and procedures.

• Verify the accuracy of claim information and ensure all necessary documentation is complete.

• Identify and resolve discrepancies or issues with claims.

• Communicate with healthcare providers, patients, and insurance companies to obtain additional information or clarify details.

• Maintain up-to-date knowledge of industry regulations and standards.

• Ensure compliance with all relevant laws and regulations.

• Prepare detailed reports and documentation as required.

Qualifications:

• High school diploma or equivalent; additional education or certification in healthcare administration or a related field is preferred.

• Minimum of 2 years of experience in medical claims examination or a related role.

• Strong knowledge of medical terminology, coding, and billing procedures.

• Excellent analytical and problem-solving skills.

• Proficient in using claims processing software and other relevant computer applications.

• Strong attention to detail and accuracy.

• Excellent communication and interpersonal skills.

Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our program provides employees with the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance