Claims Examiner (Commercial, Medicaid & Medicare)
Job Number: NR914935421
Pay Rate: $19.8-22.45 / hour
Job Description
Claims Examiner | Direct Hire
- Location: Pittsburgh, PA 15233 – (North Side)
- (Hybrid) - The role includes a mix of on-site and remote workdays. Specific schedules may vary by team or role.
- Schedule: Monday – Friday, daylight schedule
- Employment Type: Full-Time, Regular (Permanent)
- Starting Rate: $19.80 – $22.45 per hour (Initial pay is targeted up to the 25th percentile of the full range)
Why Apply Through Us?
Partner with a dedicated recruitment team that serves as your personal advocate. We provide concierge-level support through every step of the employment lifecycle—from resume review to interview prep—at no cost to you.
This is a Direct Hire opportunity. You will be a permanent, full-time employee of a leading healthcare organization from day one; this is not a temporary or contract assignment.
Compensation & Career Growth
- Starting Range: $19.80 – $22.45 per hour.
- Long-Term Earning Potential: This position offers a clear path for financial growth. Through continuous learning, advanced education, and consistent high performance over time, employees have the opportunity to earn up to $30.40 per hour as they progress within the role.
- Tuition Reimbursement: Take advantage of exceptional programs to support your continued education and help you reach your long-term salary goals.
Premier Benefits
- Work-Life Balance: Generous Paid Time Off (PTO), paid holidays
- Financial Security: Retirement plans with an employer match.
- Comprehensive Coverage: Full medical, dental, and vision insurance, plus life and disability coverage.
The Role
As a Claims Examiner, you will join the Operations department to manage the adjudication of standard to moderate healthcare claims.
- Process claims and Coordination of Benefits (COB) accurately and efficiently.
- Resolve outstanding holds and process batch edit errors.
- Maintain strict confidentiality of insured/employee information.
- Collaborate with team members to ensure client satisfaction and meet production standards.
Mandatory Requirements:
- Education: High school diploma or equivalent
- Knowledge: Proficiency in Medical Terminology, ICD-9/10, and CPT coding
- Experience: Minimum 1 year of health insurance claims processing experience
- Systems: Comfort with MS Office, QWERTY keyboarding, and knowledge of Medicaid/Medicare products.
- Aptitude: Strong interpersonal skills and the ability to prioritize tasks in a fast-paced environment.
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