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Health Insurance Claims Examiner

Vantage Health Plan, Inc. Monroe Full-Time
$13.00 - $15.00 / hour
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At Vantage Health Plan, we specialize in taking care of people: our members, our patients, and our employees. We offer competitive salaries and great benefits! Benefits include: Health, Dental, Life, Accidental Death and Dismemberment, Long Term Disability, Paid Time Off, and 401(k).

Vantage is currently looking for a Health Insurance Claims Examiner to work at our downtown Monroe location.

Job Summary: The Health Insurance Claims Examiner is responsible for examining and processing Medicare, Commercial, and/or Institutional claims timely and in accordance with plan guidelines. 

Essential Duties and Responsibilities:

  • Examine and process claims timely and accurately
  • Review auto-adjudication of claims
  • Review plan guidelines to ensure benefits are coded appropriately
  • Meet production and accuracy requirements
  • Audit claims reports for accuracy
  • Assist in preparation for check-runs
  • Provide assistance to various departments regarding claims inquiries as needed 

Marginal Duties:

  • Light data entry
  • Assist in compiling reinsurance details
  • Help with imaging/mail room as needed
  • Other duties as assigned

Knowledge, Skills, and Abilities:

  • Bachelor's Degree and/or 2 years of relevant experience
  • Ability to work under stress and meet daily deadlines
  • Ability to thrive in a structured, production-driven environment
  • Highly organized with strong attention to detail and accuracy
  • Strong verbal and written communication skills
  • Ability to work well independently and within a team
  • Ability to perform simple calculations
  • Attendance and punctuality are a must
  • Working knowledge of Microsoft Office Suite (Word, Outlook, Excel)

Supervisory Responsibilities:

  • None

Supervision Received:

  • Works under close supervision of the Director of Claims, Data Entry, and Imaging

Working Conditions:

  • Overtime occasionally required
  • Due to the nature of this position, distractions must be limited to ensure accuracy and production goals are met:
  • Cell phone use restricted to break times and lunch hour
  • Talking/visiting is limited
  • Break and lunch times may be adjusted by the Director as needed according to claims volume

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel, reach with hands and arms, and talk or hear. The employee is frequently required to stand and walk. The employee must regularly lift and/or move up to 10 pounds and frequently lift and/or move up to 30 pounds.

Recommended skills

Attention To Detail
Claims
Health Insurance
Medicare
Verbal Communication
Written Communication
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In 1994, Vantage Health Plan, Inc., was formed by physicians who wanted to provide quality healthcare coverage through the teamwork of physicians and their patients. That commitment to quality and care is still inherent in Vantage today. Vantage’s membership has grown steadily over the past 20 years, now providing health insurance coverage for nearly 40,000 members and contracting with over 15,000 healthcare providers. Vantage prides itself in offering friendly, excellent customer service and quality healthcare products.


Vantage continues the belief that health insurance should be affordable and customer service should be local and compassionate. With the corporate offices in Monroe, Louisiana, Vantage has expanded with office locations in Baton Rouge, Shreveport, Oak Grove, Mangham, and more!


With products including Individual, Medicare Advantage, and plans for Louisiana State employees with the Office of Group Benefits, Vantage has health insurance for everyone!


Vantage is a visible example of commitment to the lives of our members and community. Vantage hosts tailgating parties for the community during several events including the Warhawk Triathlon and Dragon Boat Races. Employees also volunteer in the Susan G. Komen Race for the Cure, Alzheimer’s Association Memory Walk, Ouachita Council on Aging’s Shindig, Party on the Rooftop, and the American Heart Association’s Go Red event. Vantage’s co-ed softball team also participates every year in the community league.


Nothing, however, is more evident of Vantage’s commitment than the ongoing beautification efforts of downtown Monroe. In addition to completely renovating every floor of the Vantage Tower (formerly Ouachita National Bank), Vantage also purchased the former Central Bank Building, located at 300 DeSiard Street. Along with the renovations to the Vantage Central Building, the new Central Park was added as a symbol of the rebirth and renewal of downtown Monroe. The park offers employees a place for relaxation and the citizens of Monroe something to admire. In early 2017, Vantage opened the Vantage State Building in downtown Monroe. This building, built in 1925, began as the Virginia Hotel and became the State Office Building. The six-story office building houses Vantage’s Marketing and Member Services departments, a beautifully renovated lobby and mezzanine, the “Rooftop Garden” for meetings and private events, and two large retail spaces on the ground floor.


Currently, Vantage owns a total of seven buildings and five parking lots downtown.

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