Claims Examiner

Job overview

The Claims Examiner role is remote. Compensation is $18–$23 per hour. First Choice Health is a provider-owned healthcare organization that administers health benefits and works to make healthcare access easier. The examiner reviews and adjudicates assigned claims accurately and on time, applying contracts, policies, and reference materials. The work supports reliable claims processing and the organization's service to its clients and members while protecting confidential health information.

What you'll do

• Process EDI errors and institutional, professional, and dental claims
• research and resolve claims using contracts, policies, reference materials, and online tools
• meet department productivity, quality, and accuracy standards
• protect confidential protected health information
• provide feedback on plan benefits, benefit quoting tools, and system issues
• process action requests, correspondence, audit and quality work items, and claim adjustments.

What we're looking for

Skills & competencies

claims examiner

first choice health

remote

$18–$23 per hour

claims adjudication

edi errors

dental claims

professional claims

institutional claims

cpt

icd-10

hcpcs

Work arrangement

• Weekend coverage required

Benefits & perks

• Medical, vision, dental, life insurance, short- and long-term disability, HSA with company contributions, FSA, 401(k) with employer match, profit sharing, PTO, paid holidays, community service, tuition reimbursement, EAP, and wellness program.

Why this role

Remote claims adjudication role with a path to Claims Examiner II after sustained production, quality, and attendance performance

About the employer

First Choice Health Network Inc is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.