Claims Examiner (French) Position Available In Miami-Dade, Florida

Claims Examiner (French) Jobus Coral Gables, FL 33133 We are seeking a detail-oriented and analytical Claim Examiner to join our claims operations team. The successful candidate will be responsible for reviewing, analyzing, and processing medical claims in accordance with policy terms, regulatory requirements, and internal procedures.

Key Responsibilities:

Examine and process incoming health insurance claims to determine eligibility, benefit coverage, and payment amounts. Review supporting documentation, such as medical records and provider notes, to ensure claims meet policy guidelines. Identify and investigate discrepancies, potential fraud, or billing errors. Communicate with providers, policyholders, and internal departments to gather additional information or clarify claim details. Maintain detailed and accurate records of claims activity and decisions. Participate in ongoing training to stay current with healthcare regulations, coding updates, and company procedures.

Qualifications:

High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, insurance, or a related field preferred. Minimum of 1 year of experience in health insurance claims examination or medical billing. Excellent attention to detail and organizational skills. Strong analytical and decision-making abilities. Effective written and verbal communication skills. Proficient with claims processing software and Microsoft Office Suite. French is a plus.

Job Type:

Full-time Pay:

$23.00 – $25.00 per hour

Schedule:

Monday to

Friday Language:

French (Preferred) Ability to

Commute:

Coral Gables, FL 33133 (Required)

Work Location:

In person