Job Description

Claims Examiner job description

This Claims Examiner job description template includes the list of most important Claims Examiner’s duties and responsibilities. It is customizable and ready to post to job boards. Use it to save time, attract qualified candidates and hire the best employees.

Claims Examiner job description template

Claims Examiner job profile

Generally, Claims Examiners are responsible for managing, investigating and processing any claims a company receives.

In order to attract Claims Examiner that best match your needs, it is very important to write a clear and precise Claims Examiner job description

Claims Examiner job description

We are looking for a Claims Examiner to join our team.As the Claims Examiner in our company, you will be responsible for timely claims processing, adjudication, management and claim research.

In addition, you will have the opportunity to participate in enhancing claim processing procedures, audits, and special projects.

We are expecting you to be highly detail-oriented, precise, and to have the ability to initiate.

Claims Examiner duties and responsibilities

  • Keep the department’s claim inventory current and clear
  • Edit and adjust queues by process claims
  • Process claims according to verification of eligibility, interpretation of program benefits, and provider contracts
  • Correctly match authorizations
  • Coordinate benefits and other health coverage
  • Adhere to established standards
  • Identify and report billing errors
  • Collaborate with team to improve processes

Claims Examiner requirements

  • Excellent ability to produce accurate and precise work in a fast-paced environment
  • A minimum of X years prior work experience in claims operations management
  • Hands-on working knowledge and background in claim processing
  • Good interpersonal and communication skills
  • A high school diploma
  • College degree preferred
See TalentLyft in action

Applicant Tracking, Recruitment Marketing, Sourcing and Talent CRM software are powerful alone, but unstoppable when used together!


Related content

Explore more topics

  • Sourcing Candidates

    Master the art of sourcing candidates with strategies that help you find and attract top talent. Learn how to leverage social media, job boards, networking, and recruitment tools to expand your talent pool. Improve your sourcing techniques to identify qualified candidates faster and build a strong, diverse pipeline for your hiring needs.

  • Recruitment Trends

    Stay up-to-date with the latest trends shaping the recruitment industry. From AI and automation to remote hiring and employer branding, discover how modern recruitment strategies are evolving. Learn to adapt to these trends and enhance your talent acquisition process to attract top candidates in a competitive market.

  • Mobile Recruitment

    If you think job seekers look for jobs in the newspaper or on their desktop computers, think again. IT's 2023. and people use their phones for everything, including job searching. Learn how to meet them there and adjust your recruitment process to turn mobile recruitment into your biggest advantage.

  • Diversity Equity and Inclusion (DEI)

    Diversity, equity, and inclusion (DEI) have become key focuses in building a thriving workplace culture—and for good reason. In our DEI Hub, we provide strategies, insights, and best practices to help HR professionals, business leaders, and change-makers champion a more inclusive and equitable workforce. Join us in fostering diversity and empowering employees by exploring a wide range of DEI topics, from inclusive hiring practices to creating a workplace where all voices are heard and valued.

  • Culture Fit

    Ensure culture fit in your hiring process with strategies that align candidates’ values and behaviors with your company’s culture. Learn how to assess cultural compatibility during interviews, foster a positive workplace environment, and build a team that not only excels in skills but thrives within your organization's unique culture.

  • Turnover and Retention

    Reduce turnover and improve retention with proven strategies. Learn how to identify the causes of employee turnover, implement retention programs, and create a positive workplace culture that fosters loyalty. By focusing on employee engagement and satisfaction, you can retain top talent and strengthen your organization’s long-term success.

Simple and affordable recruitment software