UST HealthProof · 9 hours 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 integrated solutions for health plan operations. The Claims Examiner II is responsible for adjudicating healthcare claims, ensuring accuracy and compliance with client guidelines, while also mentoring junior team members and collaborating on special projects.
Hospital & Health Care
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
Qualification
Required
Solid understanding and ability to analyze claim data
High School degree required
1 - 3 years of healthcare claims processing experience
Willingness to learn new skills
Team collaborator
Strong work ethic
The ability to adapt quickly to a fast-paced environment
A self-starter and quick learner
Team player with an ability to collaborate
Preferred
ICD-10 CPT and HCPCS coding, is a plus
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 HealthProof
UST HealthProof offers risk adjustment, quality programs, and healthcare payer technology services. It is a sub-organization of UST.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2025-09-04Acquired
Leadership Team
Kevin Adams
Chief Executive Officer
Beth Maxwell
VP Product Delivery and Partnerships
Recent News
2025-12-06
Precedence Research
2025-11-21
2025-11-07
Company data provided by crunchbase