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Medical Claims Examiner

Salary National Average

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48860.0000 57110.0000 70670.0000

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Short Description:

A Medical Claims Examiner is responsible for evaluating healthcare insurance claims to determine their validity and ensure they comply with policy terms and regulatory guidelines. Their duties include reviewing medical records, verifying the accuracy of diagnoses and treatments, and ensuring that claims meet the necessary criteria for reimbursement. Medical Claims Examiners may also investigate discrepancies, approve or deny claims, and work closely with healthcare providers to resolve complex cases. Strong analytical skills, attention to detail, and knowledge of medical terminology and insurance regulations are essential for success in this role, as Medical Claims Examiners help maintain the integrity of the claims process.

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