Claims Examiner
WelbeHealth(29 days ago)
About this role
The Claims Examiner at WelbeHealth supports the Health Plan Services team by ensuring claims are processed accurately and in compliance with contractual, federal, and state requirements. The role contributes to maintaining claims processing rules and supports internal and external partners regarding claim decisions and statuses. This position helps uphold high-quality care delivery for contracted specialty provider partners within the organization’s care model.
Required Skills
- Claims Processing
- Claims Research
- Claims Adjudication
- Medicare
- Medicaid
- Microsoft Office
- Electronic Systems
- Regulatory Compliance
- Provider Support
- Rules Development
About WelbeHealth
welbehealth.comWelbeHealth is a full‑service senior health care provider that operates PACE (Program of All‑Inclusive Care for the Elderly) programs to deliver comprehensive, coordinated care for frail and vulnerable older adults. Its interdisciplinary teams deliver medical, behavioral, rehabilitative and social services — including primary care, nursing, therapy, home care, transportation and adult day services — so participants can remain safely and independently at home. The organization emphasizes quality, compassion and value while integrating Medicare and Medicaid benefits to manage care and costs for seniors.
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