Job Description

Job Description

Job Description

Claims Examiner | Direct Hire

• Location: Pittsburgh, PA 15233 – (North Side)
• (Hybrid) - The role includes a mix of on-site and remote workdays. Specific schedules may vary by team or role.
• Schedule: Monday – Friday, daylight schedule
• Employment Type: Full-Time, Regular (Permanent)
• Starting Rate: $19.80 – $22.45 per hour (Initial pay is targeted up to the 25th percentile of the full range)

Why Apply Through Us?

Partner with a dedicated recruitment team that serves as your personal advocate. We provide concierge-level support through every step of the employment lifecycle—from resume review to interview prep—at no cost to you .

This is a Direct Hire opportunity. You will be a permanent, full-time employee of a leading healthcare organization from day one; this is not a temporary or contract assignment.

Compensation & Career Growth

• Starting Range: $19.80 – $22.45 per hour.
• Long-Term Earning Potential: This position offers a clear path for financial growth. Through continuous learning, advanced education, and consistent high performance over time, employees have the opportunity to earn up to $30.40 per hour as they progress within the role.
• Tuition Reimbursement: Take advantage of exceptional programs to support your continued education and help you reach your long-term salary goals.

Premier Benefits

• Work-Life Balance: Generous Paid Time Off (PTO), paid holidays
• Financial Security: Retirement plans with an employer match.
• Comprehensive Coverage: Full medical, dental, and vision insurance, plus life and disability coverage.

The Role

As a Claims Examiner , you will join the Operations department to manage the adjudication of standard to moderate healthcare claims.

• Process claims and Coordination of Benefits (COB) accurately and efficiently.
• Resolve outstanding holds and process batch edit errors.
• Maintain strict confidentiality of insured/employee information.
• Collaborate with team members to ensure client satisfaction and meet production standards.

Mandatory Requirements:

• Education: High school diploma or equivalent
• Knowledge: Proficiency in Medical Terminology, ICD-9/10, and CPT coding
• Experience: Minimum 1 year of health insurance claims processing experience
• Systems: Comfort with MS Office, QWERTY keyboarding, and knowledge of Medicaid/Medicare products.
• Aptitude: Strong interpersonal skills and the ability to prioritize tasks in a fast-paced environment.

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