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Medical Claims Examiner

We currently have multiple openings for our International Medical Claims Examiner position at International Medical Group. 

Claims Examiners provide a service to our policyholders by reviewing claims to determine the validity of the insurance claim filed, and identify the need for further investigations.  Examiners resolve medical/dental/life/trip cancellation claims; documenting actions; maintaining their imaging queues; maintaining quality audit standards and ensuring their outcomes are in compliance with the Certificate of Insurance, Policy and Plan Documents as well as legal and regulatory agencies.

Duties and Responsibilities:

  • Determines covered insurance losses by studying provisions of policy or certificate.
  • Establishes proof of loss by studying proof of claim; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable claims.
  • Documents medical claims actions by completing forms, reports, logs, and records.
  • Resolves claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.
  • Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
  • Maintains quality customer services by following core values.

Qualities of our desired candidate:

  • Knowledge of ICD-9 and ICD-10
  • Computer skills and proficiency in operating common office equipment
  • Documentation Skills, Data Entry Skills, Analyzing Information , Problem Solving
  • FDA Health and HIPAA Regulations, Statistical Analysis

Perks:

  • On site fitness center
  • Casual dress
  • 401k with a 2 year vesting period
  • Short and Long term Disability after one year of employment
  • Full tuition reimbursement after one year of employment

For more than 25 years, International Medical Group® (IMG®) has provided global benefits and assistance services to millions of travelers in almost every country. Our comprehensive range of international medical and travel insurance products ensures our members are covered wherever they may go. However, IMG provides more than just insurance; we provide the Global Peace of Mind® you deserve, backed by a team of internationally based professionals committed to serving you 24/7.  

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