Experienced Managed Care Claims Examiner - U.S. Remote

Experienced Managed Care Claims Examiner - U.S. Remote

Job Type: Full-Time Work Location: U.S. Remote Work Hours: Pacific Time Zone

Position Overview

We are seeking an Experienced Managed Care Claims Examiner to join our growing healthcare operations team. This role is responsible for accurately reviewing, investigating, adjudicating, and resolving medical claims and provider dispute requests in accordance with payer guidelines, contractual agreements, regulatory requirements, and internal policies.

This is a fast-paced, production-driven role requiring strong analytical skills, attention to detail, and the ability to process a broad range of claim scenarios. Successful candidates must be comfortable navigating complex claims, applying multiple benefit and reimbursement rules, and managing a high-volume workload while maintaining quality and accuracy standards.