Location
Santa Barbara
Job Type
Full-time
Posted
June 27, 2026
Job Description
Job Summary
We are seeking an experienced Claims Examiner to join our team. In this role, you will be responsible for researching, reviewing, correcting, and resolving pended medical claims while ensuring compliance with company policies, procedures, and regulatory guidelines. The ideal candidate will have prior claims examination experience and a strong understanding of medical claims processing, claims adjudication, and denial management.
Key Responsibilities
+ Research, review, and resolve pended medical claims in a timely and accurate manner.
+ Determine claim payment eligibility based on established policies, procedures, and benefit guidelines.
+ Analyze and adjudicate medical claims while ensuring accuracy and compliance.
+ Review audit reports and take appropriate corrective actions as needed.
+ Investigate and respond to claim discrepancies, denials, and processing issues.
+ Maintain correspondence related to required ...
We are seeking an experienced Claims Examiner to join our team. In this role, you will be responsible for researching, reviewing, correcting, and resolving pended medical claims while ensuring compliance with company policies, procedures, and regulatory guidelines. The ideal candidate will have prior claims examination experience and a strong understanding of medical claims processing, claims adjudication, and denial management.
Key Responsibilities
+ Research, review, and resolve pended medical claims in a timely and accurate manner.
+ Determine claim payment eligibility based on established policies, procedures, and benefit guidelines.
+ Analyze and adjudicate medical claims while ensuring accuracy and compliance.
+ Review audit reports and take appropriate corrective actions as needed.
+ Investigate and respond to claim discrepancies, denials, and processing issues.
+ Maintain correspondence related to required ...