We are seeking an experienced Claims Examiner for a full-time, temp-to-hire opportunity in the Shreveport and Bossier City, LA area. This role is ideal for a detail-oriented insurance claims professional with experience reviewing, analyzing, and adjudicating medical, dental, and short-term disability claims.
The Claims Examiner will work in a professional healthcare insurance environment where accuracy, compliance, and timely service are essential. This opportunity offers a supportive team setting, strong leadership, clear expectations, and a collaborative culture focused on quality, accountability, and continued professional growth. Candidates who enjoy problem-solving, interpreting benefits, reviewing healthcare documentation, and helping resolve claim issues will be well suited for this position.
Key Responsibilities
- Review, analyze, and process medical, dental, and short-term disability claims for accuracy, eligibility, coverage, and benefit levels.
- Evaluate claim documentation, medical information, coding, and plan provisions to determine payment eligibility, adjustments, medical necessity, or denials.
- Process secondary claims and apply coordination of benefits requirements to determine payer responsibility.
- Communicate with providers, patients, and group representatives to obtain missing information and support timely claim resolution.
- Document claim activity, decisions, correspondence, adjustments, appeals, and issue resolution details within the claims management system.
- Ensure claims are processed in compliance with HIPAA, regulatory requirements, company policies, productivity standards, and accuracy expectations.
Compensation and Benefits
- Pay range: $13.00 to $15.00 per hour.
- Job type: Temp-to-hire.
- Schedule: Full-time.
- Benefits: Competitive pay plus benefits.
Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf
For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Required Qualifications and Skills
- Review and adjudicate medical, dental, and short-term disability claims.
- Analyze benefit plans, eligibility, coverage requirements, coding, and claim documentation.
- Process secondary claims and apply coordination of benefits guidelines.
- Maintain accurate claim records and support timely communication with providers, patients, and group representatives.
- 1 to 2 years of claims processing, claims examining, insurance, healthcare administration, or related experience preferred.
- Knowledge of medical, dental, disability, or healthcare claims processes.
- Ability to review plan provisions, claim documentation, eligibility information, and benefit levels with strong attention to detail.
- Understanding of HIPAA, confidentiality standards, regulatory compliance, and claims processing accuracy requirements.
- Strong data entry, documentation, communication, and follow-up skills.
- Ability to work in a fast-paced professional office environment while meeting productivity and accuracy standards.
- Dependable, organized, analytical, and comfortable resolving claim issues with professionalism.
Preferred Qualifications
- Experience processing secondary claims and applying coordination of benefits.
- Familiarity with claims management systems or healthcare insurance software.
- Prior experience communicating with providers, patients, or group representatives regarding claim status, documentation, or issue resolution.
Please send your resume to sfuentes@appleone.com Thank you!!