Claims Examiner Job at Randstad (Winnipeg)

Claims Examiner Senior

The Claims Examiner Senior is responsible for reviewing, analyzing, researching,...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Associate's degree or equivalent job-related experience required
Minimum of 3 years’ experience processing medical claims in the healthcare industry
Must be knowledgeable about medical terminology, CPT, HCPCS, ICD-10, Revenue Codes, CMS-1500 and CMS-1450/UB-04 claim forms and reimbursement methodologies
Must have excellent written, verbal, organizational and interpersonal communication skills
Must be proficient in Microsoft Office, Power Point, Excel, Word, Outlook, spreadsheet, and database skills

Job Responsibility

Analyze medical claim information and take appropriate action for payment resolution in accordance with policies and procedures, desktops, processing guidelines, and federal regulations
Process medical claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms from facilities, physicians, Home Health, Durable Medical Equipment providers, laboratories, etc
Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes
Process provider refunds, reconsiderations, and direct member reimbursements
Process medical claim adjustments, recovery of claim overpayments, and execution of claim batch adjudication
Solve moderately complex claims and escalate issues to the Claims Team Lead, Supervisor or Manager
Assist with database improvements and testing for system upgrades, conversions, or implementation of new processes
Serves as a resource to assist with training new associates, retraining current associates on new/updated desktops/policies and reports staff progress, deficiencies, and training needs to management
Sets high standards of performance and promotes teamwork to achieve established team goals, while maintaining a positive, professional attitude
Contacting/responding to internal and external customers for resolution on claim issues

Fulltime

Supervisor, Claims Examiners

The Supervisor, Claims Examiners is responsible for overseeing a team of risk ma...

Location

United States , Grand Rapids

Salary:

Not provided

Meijer

Expiration Date

Until further notice

Requirements

Associate's degree in business, insurance, or a related field
Minimum of two (2) years of experience in general liability claims handling
At least one (1) year of previous supervisory or leadership experience
Strong knowledge of general liability insurance policies and regulations
Excellent analytical and problem-solving skills
Effective communication and interpersonal skills
Ability to manage multiple priorities and meet deadlines
Proficiency in claims management software and Microsoft Office Suite

Job Responsibility

Supervise and mentor a team of risk management examiners
Review and approve claims settlements within authority limits, as decided by the company
Ensure timely and accurate processing of claims, while holding examiners to a high level of customer service
Handle complex and high-value claims
Provide training and development opportunities for risk management examiners
Monitor and ensure compliance with company policies, procedures, and industry regulations
Assist with implementation of claims handling strategies to improve efficiency and effectiveness
Conduct regular audits of risk management examiner claim files to ensure quality and accuracy
Collaborate with other departments, such as legal, asset protection and safety, to resolve claims issues
Prepare reports on claims activities and performance metrics for leadership as requested

What we offer

Weekly pay
Scheduling flexibility
Paid parental leave
Paid education assistance
Team member discount
Development programs for advancement and career growth

Fulltime

Customer Support Representative

As a Customer Service Representative, You will interact with customers to provid...

Location

Mexico , Guadalajara

Salary:

Not provided

Helpware

Expiration Date

Until further notice

Requirements

6 plus months of experience in customer service-related field
Microsoft Office skills
Communication, Written - Ability to communicate in writing clearly and concisely
Communication, Oral - Ability to communicate effectively with others using the spoken word
Accountability - Ability to accept responsibility and account for his/her actions
Customer Oriented - Ability to take care of the customers’ needs while following company procedures
Working Under Pressure - Ability to complete assigned tasks under stressful situations
Problem Solving - Ability to find a solution for or to deal proactively with work-related problems
Detail Oriented - Ability to pay attention to the minute details of a project or task
Active Listening - Ability to actively attend to, convey, and understand the comments and questions of others

Job Responsibility

Confer with customers by telephone or by email to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints
Check to ensure that appropriate changes were made to resolve customers' problems
Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken
Resolve customers' service or billing complaints by performing activities such as exchanging products or services, refunding money, or adjusting bills
Complete contract forms, prepare change of address records, or issue service discontinuance orders, using computers
Refer unresolved customer grievances to designated departments for further investigation
Determine charges for services requested, collect deposits or payments, or arrange for billing
Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments
Order tests that could determine the causes of product malfunctions
Obtain and examine all relevant information to assess validity of complaints and to determine possible causes

Parttime

Call Centre Claims Examiner

Working as a call centre claims examiner, you'll bring a strong background in th...

Location

Canada , Mississauga

Salary:

55000.00 - 57000.00 CAD / Year

Randstad

Expiration Date

February 19, 2026

Requirements

RN or equivalent certification required
5+ years experience in the assistance industry (contact centre/claims processing role)
Technologically proficient with MS office, and various claims management software
Strong communication skills in English (French is a strong asset)
Independent worker with the ability to manage competing priorities

Job Responsibility

Apply medical knowledge to assess claims for consistency/appropriate course of action taken
Communicate with internal teams and clients consistently and throughout the process
Update and maintain accurate records of all claims/actions/communications
Speak with healthcare providers, clients, and other stakeholders to gather information
Review claims to determine validity and accuracy

What we offer

fully remote work
Monday-Friday 8:30-5pm
3 weeks vacation
personal days
health insurance

Fulltime

Claims officer

Location

Hong Kong , Hong Kong

Salary:

19000.00 - 20000.00 HKD / Month

Randstad

Expiration Date

January 22, 2026

Requirements

Bachelor’s degree in any discipline
Good command of written & spoken English and Cantonese
Good speaking Mandarin is preferred
Proficient in Excel, MS Word and PowerPoint

Job Responsibility

Handle, examine, and settle claims in line with company guidelines
Address inquiries from policyholders, brokers, and other relevant parties
Assist the manager in implementing initiatives to enhance performance
Foster positive relationships with all stakeholders

!

Claims Officer

The role of Claims Officer involves processing medical claims for clients in the...

Location

Philippines , Makati

Salary:

Not provided

Allianz

Expiration Date

Until further notice

Requirements

1-2 years experience in a Medical Claims role is required
Strong Knowledge of Microsoft Office (Excel, Word)
A highly customer-focused individual with strong interpersonal, communicative and accuracy skills
Team player
Ability to demonstrate sounds work ethics
Can work with minimal supervision and comfortable working with deadlines
Must be willing to work onsite in Makati first 6 months
Fluent English

Job Responsibility

Examine and process Claims within the agreed company SLA to guarantee customer satisfaction and retention
Use Allianz Partners client database accurately and effectively to ensure reports generated give a true reflection of the department’s workload, which consequently facilitates effective target planning
Contribute to the team and departmental productivity targets so that the agreed SLA is achieved
In line with the company’s policy on cost containment identify duplicate payments, overbilling, up coding, possible non-disclosure and fraudulent claims
Respond to customer enquiries accurately and professionally and if necessary, liaise with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction

What we offer

Competitive Salary
13th and 14th month guaranteed
Performance Incentive Plan / Yearly Bonus
Retirement Program and Group Life Insurance
Hybrid Work Set-up after 6 months of employment
Be part of a pioneer team

Fulltime

Sr. Accountant

The Sr. Accountant will handle accounting and financial aspects for multiple ent...

Location

United States , Boston

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience as a Sr. Accountant or in a similar role
Proficiency in Account Reconciliation
Ability to handle Balance Sheet Reconciliation effectively
Experience with Bank Reconciliations
Knowledge and experience in General Ledger
Proficiency in creating and managing Journal Entries
Proficiency in Microsoft Excel
Experience with Month End Close
Hands-on experience with NetSuite
Familiarity with Oracle

Job Responsibility

Oversee the accounting and financials for multiple entities
Conduct budget analysis to assist in financial planning
Examine the effects of claims on the company's financials
Review and provide guidance to the Accounts Payable team
Validate outsourced payroll to ensure accuracy
Utilize accounting software such as NetSuite, Oracle, and SAP for various tasks
Perform account reconciliations, balance sheet reconciliations, and bank reconciliations
Maintain the general ledger and make necessary journal entries
Use Microsoft Excel for data analysis and reporting
Ensure timely completion of month-end close activities.

What we offer

Medical, vision, dental, and life and disability insurance
Eligibility to enroll in 401(k) plan
Free online training
Access to top jobs and competitive compensation.

Fulltime

FLEX Claims Support Specialist

The Claims Support Specialist will provide administrative support for Claims Ope...

Location

United States , Bethesda, MD

Salary:

19.95 - 33.12 USD / Hour

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

High School Diploma or GED
1+ years equivalent/relevant experience
Experience in Microsoft Office applications: Excel, Word, Teams, SharePoint and PowerPoint
Demonstrated ability to manage multiple projects independently and collaboratively
Strong analytical, interpersonal, and communication skills (oral and written)

Job Responsibility

Review and assign International Claims to AIG (MIRA) daily
Assist EPL examiners as needed with copying files from IVOS into zipped folder
Sort, prioritize and route digital and physical mail for the department including subrogation checks
Request settlement check, act as back up for settlement check preparation and address settlement reimbursement
Assist in coordinating audit responses for AIG
Other administrative duties as assigned

What we offer

401(k) plan
Stock purchase plan
Discounts at Marriott properties
Commuter benefits
Employee assistance plan
Childcare discounts
Medical coverage
Dental coverage
Vision coverage
Health care flexible spending account

Fulltime

Claims Examiner

Randstad

Location:
Canada , Winnipeg

Category:
Insurance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 13, 2026

Expiration:
March 12, 2026

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Job Description:

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Nice to have:

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Expiration:March 12, 2026

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Job Posted:
January 13, 2026

Expiration:
March 12, 2026