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Senior Claims Examiner
Banner Health. Researching claims — auditing them for accuracy, compliance, and correct payment .
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
✓ Tailor your resumeApplicant 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