Claims Examiner I Blue Cross of Idaho - 3.5 Meridian, ID Job Details Full-time 20 hours ago Qualifications Contract review Claims payment authorization Regulatory compliance in claims processing Contract interpretation Research Incident Escalation Insurance policy review Escalation handling Medical terminology Communication skills Entry level Full Job Description Blue Cross of Idaho is seeking a Claim Examiner to review and adjudicate paper/electronic claims. Determine whether to return, deny or pay claims following organizational policies and procedures. We are looking for a Claim Examiner with:

Experience:

1-year relevant experience What a day may look like: Review claim and determine denial, acceptance or a need for further investigation. Recognize and reports issues and escalates, as necessary. Review existing claims for errors and omissions. Interpret and applies all business rules, policies and contract.

We are also looking for:

Knowledge of medical terminology Ability to complete assigned individual tasks within scope Research and navigate web-based programs Work with detailed-oriented material Follow detailed workflow and instructions Verbal & Written Communication We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.