Claims Examiner Jobs in Maine

Job Title: Medical Claims Examiner Company: Pro Search, Inc Location: Portland, ME Description: Medical office in Greater Portland is seeking an experienced Medical Claims Examiner who wants to be part of a growing organization.  This role will be responsible for verifying and editing data for routine and/or complex claims in a timely mannor.  Will also be responsible for scanning and filing claim forms.  Successful candidates will meet the following requirements. 2+ years of claims experience, preferably medical claims ability to accurrately and efficiently process claims at varying levels of complexity excellent data entry skills ability to meet department productivity standards and to maintain confidentiality knowledge of medical terminology and ICD-9, CPT and HCPCS coding preferred strong team player with excellent communication skills Compensation DOE, excellent company benefits package.

Job Title: Disability Claims Examiner - Waiver of Premium Company: Prudential Location: Portland, ME Description: Evaluate Waiver Of Premium claims for disability benefits under the Life Insurance Coverage; intervenes to bring about an appropriate outcome and provide superior service to our customers.Incumbents typically have 3-5 years of relevant experience.Builds a working relationship with claimant, employer and provider(s).Initiate process of refunds for approved claims with converted individual policies.Plans and coordinates individualized rehabilitation plans through utilization of resources available, i.e., claim discussions, Clinical Resources, Independent Medical Exam consultations.Facilitates technical aspects of the claim including documenting all claim information - phone calls, medical documentation and correspondence.Understanding the correlation between the Waiver & the Long Term Disability Benefit.Manages claim and disability within legal and contractual constraints by applying excellent judgment and assessing risk.Meets production and quality requirements for Waiver Of Premium work.Performs other duties as assigned.Remote workers are encouraged to apply as this position has the potential to be 100% remote work. Prudential and its affiliates, Newark, New Jersey are Equal Opportunity/Affirmative Action Employers and are committed to diversity in our workforce. Ability to manage multiple and changing priorities Excellent organizational and time management skills Strong written and communication skills demonstrated in previous work experience Specific experience with collaborative negotiations Proven skills in positive and effective interaction with challenging customers Experience in effectively meeting/exceeding individual professional expectations and team goals. Demonstrated analytical and math skills Ability to exercise sound judgment High level of flexibility to adapt to the needs of the organizations PC skills preferred (i.e. Windows based environment) College degree and prior claim experience preferred