Senior Claims Examiner

Health Plans, Inc.

Senior Claims Examiner processing complex medical and dental claims for HPI, a third-party administrator of health and benefit solutions. Handling auditing, training, and special projects for claims processing.

Posted 5/28/2026full-timeRemote • 🇺🇸 United StatesSenior💰 $24 - $28 per hourWebsite

About the role

Key responsibilities & impact

Process claims in accordance with plan benefits
Maintain quality average of 98%
Handle correspondence from Plan Correspondent and/or employees in a timely and efficient manner
Work with staff on filings for claim benefits investigation (pre-existing condition, medical necessity reviews, etc.)
Provides assistance to examiners to ensure accurate timely claims processing
Perform other various tasks that are deemed necessary and equitable by the claims supervisor
Special projects as determined by area management

Requirements

What you’ll need

High School diploma or equivalent
One to two years’ of HPI claims processing experience
Proficient in Microsoft Office, including Word, Excel, Outlook and PowerPoint

Benefits

Comp & perks

Medical, Dental and Vision and Prescription Drug Coverage
Fitness Reimbursement Benefit
Employee Assistance Program
Flexible Spending Account & Health Savings Account
401(k) and Quarterly Bonuses
Generous Paid-Time Off & Volunteering Opportunities
Educational Assistance & Professional Development Opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingHPI claims processingquality assurancemedical necessity reviewspre-existing condition reviews

Soft Skills

timely communicationefficiencyteam collaborationattention to detail

Certifications

High School diplomaequivalent