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Medical Claims Examiner - Hybrid/Remote - Fresno, CA

Job Description

CANDIDATES APPLYING OUTSIDE OF CALIFORNIA WILL NOT BE REVIEWED


Medical Claims Examiner - Hybrid/Remote - Fresno, CA


*100% Remote for Central Valley candidates*


Candidates are required to attend occasional trainings/meetings in Fresno, CA


The Company:

A well-respected insurance company in California with over 25 years in the business is looking to add a Medical Claims Examiner! This company is dedicated to helping clients, providing excellent customer service, and truly investing in their employees.


What’s in it for you?

  • $20.00 - $22.00/hour depending on experience
  • Remote position + few weeks of training in the office


What we need from you:

  • Experience - 1-2+ years reviewing and processing medical, dental, and vision claims
  • Education - High school diploma required, college degree
  • Software - You are proficient with data entry, Microsoft Office, Outlook, carrier websites, and other software systems as needed for the position
  • Comprehensive knowledge - You have data entry coding and medical claims processing experience


What you will be doing:

  • Comprehensive understanding of employee benefits for medical, dental, and vision plans.
  • Compares data on claim application with policy file and other company records to ascertain completeness and validity of claim
  • Refers most questionable claims to the investigator or to claim adjuster for investigation and settlement
  • Corresponds with agents and claimants to correct errors or omissions on claim forms and to investigate questionable entries
  • Examines claim adjusters' reports or similar claims/precedents to determine the extent of coverage and liability
  • Contact doctors, lawyers, or others involved to resolve claim/coverage questions
  • Perform other duties and responsibilities as assigned by management


APPLY NOW!


Why Insurance Relief™?

As a businessperson in the insurance industry, it is an advantage to partner with a staffing expert and ally who understands your unique skills and needs. With vast experience in the insurance arena, Insurance Relief™ works with brokers, carriers, and third-party administrators to locate and place the best people for positions ranging from entry-level to senior management. We invest the time to truly understand what you want to accomplish and then do our best to find meaningful opportunities.

Insurance Relief™ provides ample opportunities for you to put your skills to work so if this position is not quite the fit for you please give us a call to hear about all of the other opportunities we have available.

Medical Claims Examiner - Hybrid/Remote - Fresno, CA

San Diego, CA
Full time

Published on 08/17/2025

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