Claims Examiner
Tulsa Metro Area, Oklahoma
Category: Administrative
Reference ID: 10082021
Shortcut: http://addisongroup.gosnaphop.com/xmUfDb
Job Title: Claims Examiner
Industry: Insurance / Healthcare
Location (city, state): Tulsa, OK
Assignment Type: Direct Hire
Pay: $28/hr
Work Schedule: Mon-Fri, 8am-5pm
Benefits: This position is eligible for medical, dental, vision, and 401(k).
About The Company:
Our client is an established organization within the insurance and healthcare services industry focused on delivering accurate, timely, and high-quality claims support. The team values collaboration, attention to detail, continuous improvement, and providing responsive service to clients and business partners.
Job Description:
The Claims Examiner will be responsible for reviewing, evaluating, and processing healthcare-related insurance claims. This position requires a strong understanding of claims procedures, benefit information, documentation requirements, and applicable regulations. The ideal candidate is detail-oriented, analytical, organized, and able to communicate effectively with both internal and external stakeholders.
Key Responsibilities:
- Review submitted claims to verify eligibility, required documentation, accuracy, and applicable coverage.
- Evaluate claims using plan provisions, established procedures, and applicable benefit guidelines.
- Determine appropriate claim outcomes, including approvals, adjustments, payment calculations, or denial determinations.
- Prepare or coordinate claim-related correspondence when additional information or a denial explanation is required.
- Follow applicable federal and state regulations, privacy requirements, and internal claims procedures.
- Maintain complete and accurate records of claims, payments, adjustments, denials, and supporting documentation.
- Respond to questions from healthcare providers, clients, and internal teams regarding claim status and processing decisions.
- Identify potential payment discrepancies, including overpayments and underpayments, and escalate issues appropriately.
- Communicate with external partners and other stakeholders to obtain information necessary to complete claim reviews.
- Confirm member eligibility, benefit levels, authorizations, and coverage details as needed.
- Recognize missing or inconsistent documentation and work with the appropriate parties to resolve outstanding issues.
- Protect confidential information and follow HIPAA and other applicable privacy standards.
- Utilize claims systems, computer applications, and emerging technology tools to improve accuracy, efficiency, and service.
- Contribute to departmental projects, process improvements, and other duties as assigned.
Qualifications:
- High school diploma or equivalent required.
- At least 1 year of experience in healthcare claims processing, reimbursement, or a related field.
- Ability to interpret written policies, benefit information, procedural guidelines, and government regulations.
- Proficiency with standard computer applications, including email, spreadsheets, word processing, and database systems.
- Strong attention to detail and the ability to analyze information and identify discrepancies.
- Effective problem-solving and decision-making skills.
- Strong written and verbal communication abilities.
- Ability to manage multiple priorities and adjust to changing workloads.
- Ability to work effectively with internal teams, providers, clients, and other business partners.
Additional Details:
- This position requires a high level of accuracy and discretion when handling sensitive claims and member information.
- Candidates should be comfortable working independently while also collaborating with a broader team.
- The responsibilities listed above are representative of the position and may be modified based on business needs.
Perks:
- Competitive compensation.
- Medical, dental, and vision benefits.
- 401(k) retirement savings opportunity.
- Paid time off and company holidays.
- Employee assistance and wellness resources.
- Professional development and career growth opportunities.
- Collaborative and supportive work environment.
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
-
Insurance Follow-Up Representative
Greenville, SC
Title: Insurance Follow-Up Representative Location: Greenville, SC Compensation: $17.50 – $24.50 / hour Benefits: This position may be eligible for medical, dental, vision, and 401(k) benefits, depending on individual selections and applicable work-hou...
Recommended
-
Medical Biller
Maplewood, MN
Job Title: Medical Biller Location: St. Paul, MN, must be able to work on-site Industry: Healthcare Pay Rate: $24 - $30 / Hourly Benefits: This position is eligible for medical, dental, vision, and 401(k). Job Description: We are currently hiring for a...
Recommended
-
Denials Specialist
Houston, TX
Job Title: Denials Specialist Location: Houston, TX (Downtown) Industry: Healthcare / Revenue Cycle Management Pay: $26 - $28 / hr Job Type: Direct Hire Benefits: This position is eligible for medical, dental, vision, and 401k. About Our Client: Addiso...
Recommended
-
Healthcare Customer Service Representative
Rockville, MD
Job title: Healthcare Customer Service Representative Location (city, state): Rockville, MD - Fully Onsite Industry: Healthcare / Health Benefits / Customer Service Pay: $25–$28/hour Benefits: This position is eligible for medical, dental, vision, life...
Recommended
-
Healthcare Account Associate
Bethesda, MD
Job title: Healthcare Account Associate Location: Remote | Travel to Bethesda, MD approximately 35% Industry: Healthcare / Health Insurance Claims Pay: $75,000 - $90,000 / Annually Benefits: This position is eligible for medical, dental, vision, life i...
Recommended
-
Retina Billing Specialist
Southlake, TX
Role: Billing Specialist - Retina Location: Fully Remote Pay Range: $24 – $30 / hour Schedule: Monday–Friday, 8:00 AM–5:00 PM in the assigned practice's time zone Employment Type: Direct Hire Benefits: This role is eligible for medical, dental, vision ...
Recommended
-
Medical Billing Specialist
Houston, TX
Job Title: Medical Billing Specialist Location: Houston, TX (Must be local to Houston) Industry: Healthcare / Revenue Cycle Management Pay: $19–$25 per hour (based on experience) Benefits: This position is eligible for medical, dental, vision, and 401k...
Recommended
-
Medical Billing Specialist
Miami, FL
Job Title: Medical Billing Specialist Location: On-Site role in Minneapolis, MN Industry: Healthcare Pay Rate: $24 - $28 / hour Benefits: This position is eligible for medical, dental, vision, and 401K. Job Description: We are currently hiring for a Me...
Recommended
-
HR Specialist
Danvers, MA
Job Title: HR Specialist Industry: Cybersecurity Services Location: Remote – Eastern Time Zone Preferred Assignment Type: Temp-to-Hire Pay: $35 – $40 / hour | $80,000 salary upon conversion Work Schedule: Monday – Friday, 8:00 AM–5:00 PM EST Benefits: ...
Recommended
-
Customer Service Representative
Rockville, MD
Job Title: Participant Advocate / Customer Service Representative Industry: Healthcare Benefits / Insurance Location (City, State): Rockville, MD Assignment Type: Contract-to-Hire; anticipated conversion after approximately 6–8 months Pay: $23.00–$27.0...
Recommended
-
Medicaid Collections Specialist
Mesquite, TX
Position: Medicaid Collections Specialist (Hospital Revenue Cycle) Location: Remote (U.S. Remote; candidates from select states are not eligible) Pay Range: $23.00 – $26.00 / Per hour Benefits: This position is eligible for medical, dental, vision, and...
Recommended
-
Remote Medicaid Collector
Mesquite, TX
Role: Medicaid Collections Specialist – Hospital Revenue Cycle Location: Remote Pay Range: $23.00 – $26.00 / Per hour Start Date: ASAP Benefits: This position is eligible for medical, dental, vision and 401(k). This is a long term contract role with po...
Recommended
-
Medical Billing & Records Coordinator
Brentwood, TN
Job Title: Medical Billing & Records Coordinator Location: Brentwood, TN Industry: Healthcare / Revenue Cycle Pay: $21 / hour Benefits: This position is eligible for medical, dental, vision, and 401k. About Our Client Addison Group is partnering with a...
Recommended
-
Payroll Manager
Chantilly, VA
Position Title: Payroll Manager Location: Chantilly, VA (Hybrid – 3 days onsite) Assignment Type: Permanent Hire Compensation: $85,000–$95,000 / Annually Work Schedule: Monday – Friday, 9:00 AM – 5:00 PM Benefits: This position is eligible for Medical,...
Recommended
-
Full-Cycle Billing Specialist
Texas
Job title: Full-Cycle Billing Specialist Location: Texas Industry: Healthcare / Infusion Revenue Cycle Pay: $22.00 - $26.00 / Per Hour (Based on years of experience) Benefits: This position is eligible for medical, dental, vision, life insurance and 40...
Recommended
-
HR Specialist
Cypress Area, Texas
Position: HR Specialist Location: Cypress, TX Employment Type: Direct Hire Pay: $65,000.00 - $75,000.00 / Annually DOE Schedule: M-F (8-5:00pm) Benefits: This position is eligible for medical, dental, vision, and 401(k). Summary: A major focus of this ...
Recommended
-
Reimbursement Specialist
Westchester, IL
Job Title: Reimbursement Specialist – Liability Industry: Healthcare / Medical Billing Location: Westchester, IL (Hybrid) Assignment Type: Direct Hire Pay: $22 – $26 / hour (up to $27/hour based on experience) Work Schedule: Full-time, Monday–Friday wi...
Recommended
-
Medical Collector
Dallas, TX
Medical Collector Location: Dallas, TX Industry: Healthcare Revenue Cycle Pay: $21–$24 per hour Employment Type: Direct Hire Work Setting: Onsite Benefits: This position is eligible for medical, dental, vision, and 401(k). About Our Client Addison Grou...
Recommended
-
Pre-Litigation Case Manager
Raleigh, NC
Job Title: Pre-Litigation Case Manager Location: Charlotte, NC Type: Temp to Hire, Full time Pay: $24 - $26 per hour Work Schedule: Monday–Friday 8-5pm Overview: We are partnering with a respected law firm to identify a Pre-Litigation Case Manager to m...
Recommended
-
Payroll Specialist
Denver, CO
Role: Payroll Specialist Location: Denver, CO (on site) Salary: $60,000 - $65,000 / year DOE Benefits: This position is eligible for medical, dental, vision and 401(k) We are seeking a detail-oriented Payroll Specialist to support payroll processing fo...
Recommended
-
Medical Biller
Columbia, SC
Title: Medical Biller (Full Cycle) Location: Columbia, SC Compensation: $17.00 – $22.00 per hour Benefits: This position may be eligible for medical, dental, vision, and 401(k) benefits through Addison Group during the contract period. About the Opport...
Recommended
-
Payroll Specialist
Irvine, CA
Payroll Analyst Location: Irvine, CA Pay: $30-$35/hr Benefits: This position is eligible for medical, dental, vision, and 401(k). Position Overview The Payroll Analyst is responsible for supporting and executing payroll operations, with a primary focus...
Recommended
-
Service Manager
Vernon Hills, IL
Title: Service Manager Onsite: Monday-Friday Location: Northwest Suburbs - Chicagoland Salary: $90,000-$110,000 + Bonus Benefits: Healthcare, Dental, PTO, 401k Position Overview We are seeking an experienced Service Manager to lead all service operatio...
Recommended
-
Payroll Specialist
Charlotte, NC
Position Title: Payroll Specialist Location: Charlotte, NC, Hybrid schedule: 3 days in office, Tuesday–Thursday Compensation: $60,000 - $65,000 / Annually Employment Type: Direct Hire Benefits: This position is eligible for medical, dental, vision, and...
Recommended
-
Leave of Absence Specialist
Irving, TX
Job Title: Temporary Leave of Absence Specialist Industry: Construction / Professional Services Location: Irving, TX Assignment Type: Contract – 90+ days Pay: $35 - $40 / hour Work Schedule: Monday–Friday, 8:00 AM–5:00 PM; flexible 8-hour schedule with...
Recommended
-
Accounts Payable Manager
Austin-Round Rock-San Marcos Metro Area, Texas
Role: Accounts Payable Manager Location: Austin, TX Onsite Pay Rate: $80,000 - $85,000 / year Job Type: Full-Time Benefits: This position is eligible for medical, dental, vision, and bonus. Internal Job ID: 10081360 We are looking for an accounts pay...
Recommended
-
RN Medical Bill Auditor
Texas
Job Title: RN Medical Bill Auditor Location: Remote Compensation: $80,000 - $90,000 annually, based on years of experience Benefits: This position is eligible for medical, dental, vision, and 401(k). About the Opportunity: Our client is a large, missio...
Recommended
-
Administrative Assistant
Nashville, TN
Job Title: Claims Administrative Assistant Industry: Logistics Location (city, state): Nashville, TN (37205) Assignment Type: 4–5 Month Contract Pay: $18–$21/hour Work Schedule: Monday–Friday, 8:00 AM–5:00 PM; Fully Onsite Benefits: This position is el...
Recommended
-
Accounts Payable Supervisor
Irvine, CA
Position Title: AP Supervisor Location: Costa Mesa, CA – Hybrid (4 days in office, 1 day remote) Assignment Type: Direct Hire; Compensation: $75,000 – $90,000 + discretionary bonus Work Schedule: M–F, 9–5 Benefits: This position is eligible for Medical...
Recommended
-
Accounts Payable Time & Expense Clerk
Santa Ana, CA
Position Title: Accounts Payable Time & Expense Clerk Location: Santa Ana, CA – On-Site Assignment Type: Temp-to-Permanent Compensation: $26.00 – $27.00 / Per Hour Work Schedule: Monday–Friday, 9:00 AM–5:00 PM Benefits: This position is eligible for Me...
Recommended