Claims Examiner

firstsourc
Remote, US
Category Finance
Remote
Job Description
Firstsource Solutions is seeking a Claims Examiner to evaluate insurance claims and determine compensation. The role requires a focus on medical terminology, regulatory compliance, data analysis, and excellent communication skills. Claims examiners review policy coverage, damages, and supporting documentation to ensure fair and accurate adjudication.

Requirements

  • Understanding of medical insurance policies (HMO, PPO, EPO, etc.).
  • Familiarity with coordination of benefits (COB) and subrogation.
  • Adjudication rules application based on policy provisions.
  • Strong data analysis skills.
  • Strong communication skills.
  • Attention to detail.
  • High accuracy in reviewing claims data.
  • Ability to manage multiple claims or inquiries within strict turnaround times.
  • Ethical judgment and discretion.
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