Senior Claims Examiner

Banner Health

Senior Claims Examiner at Banner Health auditing claims and handling escalated issues across Medicare plans. Reviewing claims, creating reports, and supporting complex claims resolution processes.

Posted 5/15/2026full-timeRemote • Arizona, California, Colorado, Nevada, New York, Wyoming • 🇺🇸 United StatesSenior💰 $21 - $32 per hourWebsite

About the role

Key responsibilities & impact

Researching claims — auditing them for accuracy, compliance, and correct payment
Managing escalated and complex claims issues
Reviewing emails for encounters, outside vendors, and special projects
Creating reports to track trends and quality opportunities
Supporting mass adjustment efforts
Acting as a go-to subject matter expert for tricky claim questions

Requirements

What you’ll need

High school diploma/GED or equivalent working knowledge
A minimum of three to four years experience in Medical and/or Dental claims adjudication in an automated environment
Excellent understanding of medical terminology, contract and benefit interpretation, CPT, HCPCS and ICD-9/ICD-10 coding
Working knowledge of Medicare, AHCCCS, Self-funded and/or commercial insurance plans
Strong oral and written communication skills
Effective interpersonal skills and attention to detail and accuracy

Benefits

Comp & perks

Health insurance
401(k)
Paid time off
Flexible work hours
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims auditingclaims adjudicationmedical terminologycontract interpretationbenefit interpretationCPT codingHCPCS codingICD-9 codingICD-10 coding

Soft Skills

oral communicationwritten communicationinterpersonal skillsattention to detailaccuracy

Certifications

high school diplomaGED