Medical Claims Examiner

As a Claims Adjudicator (Medical Claims/Medical Malpractice) at our company, your role will involve reviewing and processing medical claims to ensure accuracy and compliance with regulations and policies. You will also handle claims related to medical malpractice, assessing liability and determining appropriate actions. Your decision-making skills will be crucial as you make informed decisions on claims, considering medical records, policy terms, and relevant laws and regulations. Your qualifications for this role should include at least 6 years of experience in claims adjudication, preferably in the medical or insurance industry. A strong understanding of medical terminology, procedures, and practices is essential. You should possess excellent analytical and problem-solving skills to interpret complex medical information effectively. Additionally, strong communication and interpersonal skills are required to collaborate with healthcare providers, policyholders, and other stakeholders. Experience in the insurance industry, particularly in claims adjudication, is highly valued for this position. Knowledge of medical practices, procedures, and terminology is also essential.,