Claims Examiner I

Blue Cross of Idaho is seeking a Claims Examiner to review and adjudicate paper/electronic claims. Determine whether to return, deny or pay claims following organizational policies and procedures.

We are looking for a Claims Examiner with:

Experience: 1-year relevant experience

What a day may look like:

• Review claim and determine denial, acceptance or a need for further investigation.
• Recognize and reports issues and escalates, as necessary.
• Review existing claims for errors and omissions.
• Interpret and applies all business rules, policies and contract.

We are also looking for:

• Knowledge of medical terminology
• Ability to complete assigned individual tasks within scope
• Research and navigate web-based programs
• Work with detailed-oriented material
• Follow detailed workflow and instructions
• Verbal & Written Communication

As of the date of this posting, a good faith estimate of the current pay range is $19.45 - $27.23. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.