UST · 1 month ago
Claims Examiner II
United States
Full-time
Remote
Entry Level
$40K/yr - $44K/yr
1+ years expUST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. The Claims Examiner II is responsible for the adjudication of healthcare claims utilizing specific policies and procedures, reviewing data within the claims processing system to determine appropriate services and benefit coverage criteria.
ConsultingInformation ServicesInformation Technology
Responsibilities
Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team leader
Be responsible for meeting productivity targets, financial and procedural accuracy standards as established by management
Mentor junior members of the team
Collaborate with other team members on special projects as assigned by the team leads; special projects can include process documentation development, training, quality audits, assisting with surge activity for the client(s), or any other project as determined by the team leader
Knowledge base around physician practices and hospital coding, billing and medical terminology, CPT, HCPCS, and ICD-10, UB04, CMS 1500, authorizations, medical terminology, and concepts of healthcare
Establish and maintain an appropriate level of communication with management to address issues and concerns and take preventive measures that ensure processing accuracy and quality
Participate in projects assigned by the team leader; these projects may include provider data, authorizations, enrollment, or other activities
Qualification
Required
Solid understanding and ability to analyse claim data
ICD-10 CPT and HCPCS coding, is a plus
High School degree required
1 – 3 years healthcare claims processing experience
Willingness to learn new skills
Team collaborator
Strong work ethic
Benefits
Full-time, regular employees accrue up to 16 days of paid vacation per year
Receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year)
10 paid holidays
Eligible for paid bereavement leave
Eligible to participate in the Company’s 401(k) Retirement Plan with employer matching
Eligible for medical, dental, and vision insurance
Basic life insurance
Accidental death and disability insurance
Short- and long-term disability benefits
May purchase additional voluntary short-term disability benefits
Participate in a Health Savings Account (HSA)
Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses
Potential for quarterly incentive-based bonuses and or commissions depending on role
Company
UST
UST is a Digital Transformations Solutions Provider.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$250MKey Investors
Temasek Holdings
2018-06-27Private Equity· $250M
Leadership Team
Krishna Sudheendra
CEO
Alexander Varghese
Chief Administrative Officer & COO
Recent News
2026-01-05
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2025-12-31
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2025-12-18
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