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Medical Claims Examiner



Minneapolis, MN, USA
Posted on Thursday, April 27, 2023
Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
We’re looking for experienced Claims Examiners, to join our claims team. As Gravie looks to continue its Member-centric approach to healthcare, we need experienced examiners to review and adjudicate claims in our best in class claim system. With the many challenges that exist in the world of claims, Gravie offers a great environment for individuals looking to build on their career. Qualified applicants should be able to thoroughly evaluate, research and analyze claim submission, possessing a solid knowledge of national claims guidelines. The position has competitive pay and allows for flexible hours, as well as a flexible work schedules.

You will:

  • Process claims within our claim’s queues, and adjudicate based on claims rules
  • Review pended claims queues and provide expertise to address with appropriate parties
  • Periodic claims and process auditing to improve department outcomes
  • Continually meet department metrics and quality.
  • Communicate complex claims issues clearly through documentation and direct communications
  • Ability to set priorities, manage time, and work independently
  • Ability to utilize multiple applications to fulfill all job functions

You bring:

  • High School Diploma
  • 2 + years of experience processing medical claims
  • Strong knowledge of CPT/HCPC and ICD-10 code rules.
  • Ability to set priorities, manage time, and work independently
  • Basic proficiency using Windows based other computer applications
  • Functional comfort with Zoom, Microsoft Teams, or Google Meets
  • General knowledge of CMS claims submission regulations
  • Demonstrated success getting results through collaboration

Extra credit:

  • Medical Coding experience/ Certification
  • Medical Billing experience
  • Understanding of provider data
  • Previous start-up company experience
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.