Claims Examiner

Job Title:

Claims Examiner Job Description The Claims Examiner is responsible for reviewing, investigating, and evaluating claims to determine eligibility, and for negotiating claim resolutions in compliance with internal policies and state regulatory requirements. This role manages a high volume of claims and focuses on accurate, timely payments to customers and providers while maintaining exceptional attention to detail and data integrity. Responsibilities Review, investigate, and evaluate claims to determine eligibility in accordance with policies and state regulatory requirements. Ensure customers and providers receive timely and accurate payments. Handle customer reimbursement requests with a high degree of accuracy, recognizing that reimbursement payments cannot be reversed. Validate daily NHS wire payments and research and resolve any exceptions. Manage the reconciliation of Customer Preferred Pricing transactions to ensure accurate billing and payment. Assist customers and internal partners with inquiries regarding claim and reimbursement status. Analyze and validate large volumes of claims data and accurately enter information into the proprietary operating system. Perform data entry for invoices, including indexing invoices received via inbox and moving them to the appropriate location. Process and track invoice entry and invoice-related transactions as needed. Use Salesforce CRM and other systems to document, track, and manage claims and customer interactions. Complete filing and other administrative support tasks as required. Communicate effectively with internal and external customers, providing clear, professional responses and updates. Adapt to changes in processes, systems, and priorities in a fast-paced environment. Apply feedback constructively, take notes, and use available resources to improve performance and accuracy. Collaborate with team members within the Claims Management Department to meet department goals and service-level expectations. Essential Skills Minimum of 1 year of recent office experience in data entry, processing, dispatch, claims, provider relations, or a similar administrative role. Proficiency with Microsoft Office applications. Strong computer skills and the ability to work efficiently in multiple systems, including a proprietary operating system. Experience working in a fast-paced environment with changing priorities. Consistently strong attendance and reliability. Exceptional attention to detail with the ability to produce high-quality work with minimal to no errors. Efficient and accurate typing skills. Strong organizational skills with the ability to manage a high volume of claims and tasks. Effective verbal and written communication skills, including the ability to influence and collaborate with others. Ability to learn new processes and systems quickly. Self-starter mindset with strong problem-solving skills and the ability to work both independently and as part of a team. High school diploma or GED. Additional Skills & Qualifications Experience with claims processing, claim review, or claims examination. Background in customer service related to claims, invoicing, or reimbursements. Experience with invoice processing, invoice entry, and general invoicing procedures. Familiarity with reimbursement processing and an understanding that reimbursement payments allow very little margin for error. Experience using Salesforce CRM for tracking and managing customer and claim information. Demonstrated ability to adapt well to change in a dynamic, fast-paced environment. Creative problem-solving skills and the ability to be persuasive and thorough when resolving issues. Strong team-player attitude, including the ability to get along well with others, accept feedback, and apply it constructively. Ability to take detailed notes and consistently use available resources to resolve questions and improve accuracy. Work Environment This role is part of the Claims Management Department, working alongside a team of approximately 16 colleagues, including Claims Supervisors and Claims Examiners. The position is based in a brand-new, modern office in Naperville with an open, pit-style layout that fosters collaboration and high energy on the floor. The office includes a comfortable kitchen area with amenities such as a soda machine. Training lasts approximately 2 to 4 weeks, Monday through Friday from 7:30 a.m. to 4:00 p.m., and candidates must be able to work these hours during training. After training, team members may choose from schedules such as 7:00 a.m. to 3:30 p.m., 7:30 a.m. to 4:00 p.m., or 8:00 a.m. to 4:30 p.m., Monday through Friday. There is flexibility to work remotely on Mondays and Fridays after training, with on-site work required on other days. The organization is people-centric and mission-driven, focused on helping homeowners navigate unexpected events, reduce costs, and make homeownership more enjoyable. The culture emphasizes inclusivity, respect, and support for all employees, customers, and partners, and is committed to providing a workplace free from discrimination and harassment, with employment decisions based on business needs, job requirements, and individual qualifications. Job Type & Location This is a Contract position based out of Naperville, IL. Pay and Benefits The pay range for this position is $20.00 - $20.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a hybrid position in Naperville,IL.

Application Deadline This position is anticipated to close on May 1, 2026.

About Aston Carter:

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.